Healthcare Provider Details

I. General information

NPI: 1831543149
Provider Name (Legal Business Name): DONALD GROVES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 W PICO BLVD
LOS ANGELES CA
90064-2909
US

IV. Provider business mailing address

11600 W PICO BLVD
LOS ANGELES CA
90064-2909
US

V. Phone/Fax

Practice location:
  • Phone: 412-498-0020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA190511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: