Individual
KEITH DELLA GROTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18101 PRINCE PHILIP DRIVE, EMERGENCY DEPARTMENT, OLNEY, MD 20832
(301) 774-8882
Mailing address
907 WESTWOOD BLVD UNIT 310, LOS ANGELES, CA 90024-2904
(310) 692-1626
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A160993
CA
207P00000X
Emergency Medicine Physician
Primary
D0100145
MD
Other
Enumeration date
08/19/2015
Last updated
07/02/2024
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