Individual
MICHAEL J GROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9675 BRIGHTON WAY, SUITE 410, BEVERLY HILLS, CA 90210-5192
(310) 274-2525
(310) 274-5530
Mailing address
9675 BRIGHTON WAY, SUITE 410, BEVERLY HILLS, CA 90210-5192
(310) 274-2525
(310) 274-5530
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
G58694
CA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
G58694
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G586940
BLUE SHIELD
CA
01
—
1800085000
RAILROAD MEDICARE
—
Enumeration date
07/25/2006
Last updated
09/11/2025
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