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Individual
MARK STEVEN GROSSMAN
Active
Individual
MARK STEVEN GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G79624
CA
208000000X
Pediatrics Physician
G79624
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G796240
—
CA
Enumeration date
07/18/2006
Last updated
06/24/2010
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