Individual
ALEXANDER GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1144 N ORANGE GROVE AVE APT 7, WEST HOLLYWOOD, CA 90046-5489
(323) 687-0096
Mailing address
337 N LAUREL AVE, LOS ANGELES, CA 90048-2313
(323) 687-0096
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
301519
NY
2085R0202X
Diagnostic Radiology Physician
4301512721
MI
2085R0202X
Diagnostic Radiology Physician
43468
CO
2085R0202X
Diagnostic Radiology Physician
A76025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A760250
BLUE SHIELD
—
05
—
94181888
—
CO
Enumeration date
10/25/2006
Last updated
12/02/2024
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