# JEREMY IAN GROSSER, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174702377
- **Authorized official:** DR. JEREMY IAN GROSSER MD (PRESIDENT)
- **Authorized official phone:** (818) 929-2259

## Contact information

- **Practice address:** 7355 TOPANGA CANYON BLVD STE 200, CANOGA PARK, CA 91303-1244
- **Practice address phone:** (818) 885-8500
- **Practice address fax:** (818) 700-5690
- **Mailing address:** 109 DAPPLEGRAY RD, BELL CANYON, CA 91307-1050
- **Mailing address phone:** (818) 929-2259
- **Mailing address fax:** (818) 700-5690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A67128 | CA | Yes |

## Other

- **Enumeration date:** 10/24/2007
- **Last updated:** 09/04/2022