Individual
MR. TYLER GROGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1240 BROADWAY, EL CAJON, CA 92021-4994
(619) 841-1310
Mailing address
21261 S 227TH PL, QUEEN CREEK, AZ 85142-2841
(801) 891-0821
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN95400841
CA
Other
Enumeration date
01/10/2025
Last updated
01/10/2025
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