Organization
DAVID M. GROSSMAN, M.D., MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M. GROSSMAN M.D. (PHYSICIAN/OWNER)
(818) 528-1290
Entity
Organization
Contact information
Practice address
18375 VENTURA BLVD, SUITE 640, TARZANA, CA 91356-4218
(818) 908-8048
(818) 908-8072
Mailing address
5525 ETIWANDA AVE., SUITE 200, TARZANA, CA 91356-6131
(818) 528-1290
(818) 528-1295
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A52722
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A527220
BLUE SHIELD
CA
Enumeration date
05/05/2006
Last updated
05/03/2016
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