| Jeremy Ian Grosser Md Inc. | |
|
7355 Topanga Canyon Blvd Ste 200 Canoga Park CA 91303-1244 | |
| (818) 885-8500 | |
| (818) 700-5690 |
| Full Name | Jeremy Ian Grosser Md Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7355 Topanga Canyon Blvd Ste 200, Canoga Park, California |
| Authorized Official Name and Position | Jeremy Ian Grosser (PRESIDENT) |
| Authorized Official Contact | 8189292259 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy Ian Grosser Md Inc. 109 Dapplegray Rd Bell Canyon CA 91307-1050 Ph: (818) 929-2259 | Jeremy Ian Grosser Md Inc. 7355 Topanga Canyon Blvd Ste 200 Canoga Park CA 91303-1244 Ph: (818) 885-8500 |
| NPI Number | 1669484481 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 09/04/2022 |
| Medicare PECOS PAC ID | 2668490236 |
|---|---|
| Medicare Enrollment ID | O20051102001206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669484481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A67128 (California) | Primary |
| Provider Name | Jeremy I Grosser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235123373 PECOS PAC ID: 4385662956 Enrollment ID: I20051104000612 |
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