Healthcare Provider Details

I. General information

NPI: 1225242332
Provider Name (Legal Business Name): JONATHAN DAVID GROSSMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 S ASPEN ST STE A
VISALIA CA
93291-5381
US

IV. Provider business mailing address

10746 N FALCON FAIRE DR
FRESNO CA
93730-3592
US

V. Phone/Fax

Practice location:
  • Phone: 559-334-6720
  • Fax: 559-429-8240
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA98906
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA98906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: