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Organization

JOHN M. GROLLMUS, M.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN M. GROLLMUS M.D. (OWNER/ LEAD PHYSICIAN)
(707) 525-0696
Entity
Organization

Contact information

Practice address
990 SONOMA AVE, STE. 20 &21, SANTA ROSA, CA 95404-4802
(707) 525-0696
(707) 525-8404
Mailing address
990 SONOMA AVE, STE. 20 &21, SANTA ROSA, CA 95404-4802
(707) 525-0696
(707) 525-8404

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
C27979
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A93807
CA LINC FOR DR. LAPSIWALA
CA
01
PA10702
CA LINC FOR ELIZ REDICK
CA
Enumeration date
06/22/2006
Last updated
08/22/2020
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