Healthcare Provider Details

I. General information

NPI: 1942489117
Provider Name (Legal Business Name): JEFFREY W GROLIG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 WASHINGTON ST
RED BLUFF CA
96080-2746
US

IV. Provider business mailing address

1005 WASHINGTON ST
RED BLUFF CA
96080-2746
US

V. Phone/Fax

Practice location:
  • Phone: 530-221-2520
  • Fax: 530-223-2899
Mailing address:
  • Phone: 530-221-2520
  • Fax: 530-223-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY WENDALL GROLIG
Title or Position: OWNER
Credential: MD
Phone: 530-221-2520