MEDICARE: MARTHA GROSZYK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	63755	CA

General Provider Information

NPI Number	:	1518330380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA GROSZYK

Provider Business Mailing Address
First Line	:	2025 VAN NESS AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-3009
Country	:	US
Telephone Number	:	415-353-5705
Fax Number	:	415-353-5709

Provider Business Practice Location Address
First Line	:	2025 VAN NESS AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-3009
Country	:	US
Telephone Number	:	415-353-5705
Fax Number	:	415-353-5709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2015
Last Update Date	:	11/02/2015

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Directions to “ MARTHA GROSZYK ” Practice Location

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