Healthcare Provider Details

I. General information

NPI: 1831200591
Provider Name (Legal Business Name): DANIEL ESTEBAN GROSZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DANIEL E GROSZ MD

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16661 VENTURA BLVD SUITE 603
ENCINO CA
91436
US

IV. Provider business mailing address

16661 VENTURA BLVD SUITE 603
ENCINO CA
91436
US

V. Phone/Fax

Practice location:
  • Phone: 818-386-0500
  • Fax: 818-386-2019
Mailing address:
  • Phone: 818-386-0500
  • Fax: 818-386-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA49772
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA49772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: