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Individual

PHILLIP MICHAEL GROB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
339 COLLEGE AVE, SANTA ROSA, CA 95401-5117
(707) 573-0223
(707) 573-0222
Mailing address
3322 CHANATE RD, SANTA ROSA, CA 95404-1708

Taxonomy

Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
G85079
CA

Other

Enumeration date
12/13/2006
Last updated
07/08/2014
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