Healthcare Provider Details

I. General information

NPI: 1902462773
Provider Name (Legal Business Name): ANNETTE GROTHEER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 HYDE ST
SAN FRANCISCO CA
94109-4806
US

IV. Provider business mailing address

1600 NW 10TH AVE # 1140
MIAMI FL
33136-1015
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-6539
  • Fax:
Mailing address:
  • Phone: 305-243-3234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA202897
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberA202897
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: