Individual
DR. MICHAEL GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
414 E SAN BERNARDINO RD, COVINA, CA 91723-1704
(626) 915-5181
Mailing address
BOX 5010, GLENDORA, CA 91740-0735
(626) 915-5181
(626) 331-2313
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A22902
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A229020
—
CA
01
—
A22902
STATE LICENSE
CA
Enumeration date
06/29/2006
Last updated
10/23/2008
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