Individual
ANDREW GROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
17200 PALISADES CIR, PACIFIC PALISADES, CA 90272-2162
(310) 748-8405
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A135364
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/11/2011
Last updated
04/08/2022
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