Individual
KARYN L GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2001 SANTA MONICA BLVD STE 1250W, SANTA MONICA, CA 90404-2217
(310) 998-0040
Mailing address
2001 SANTA MONICA BLVD., SUITE 1250W, SANTA MONICA, CA 90404-2217
(310) 998-0040
(310) 998-0024
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
G084212
CA
207NS0135X
Procedural Dermatology Physician
199318
NY
207NS0135X
Procedural Dermatology Physician
Primary
G084212
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199318
STATE MEDICAL LICENSE
NY
01
—
74551
STATE MEDICAL LICENSE
MA
01
—
G84212
STATE MEDICAL LICENSE
CA
Enumeration date
03/07/2007
Last updated
07/21/2022
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