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Organization
KENNETH R GROSSMAN MD INC
Active
Organization
KENNETH R GROSSMAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH RANDELL GROSSMAN MD (OWNER PHYSICIAN)
(209) 383-0989
Entity
Organization
Contact information
Practice address
580 COLLINS DR, MERCED, CA 95348-3121
(209) 383-0989
Mailing address
580 COLLINS DR, MERCED, CA 95348-3121
(209) 383-0989
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
07/28/2006
Last updated
08/22/2020
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