Organization
JOHN M. GROLLMUS, M.D., INC.
Active
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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