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General NPI Number Information
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NPI Number | 1790836153
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Entity Type | Individual
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Provider Name | RAKESH K GROVER MD
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Gender | Male
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 16018 TUSCOLA RD
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City | APPLE VALLEY
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State | CA
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Zip | 92307-1329
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Country | US
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Telephone | 760-242-0375
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Fax |
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Provider Business Mailing Address
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Address Line | 16018 TUSCOLA RD
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City | APPLE VALLEY
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State | CA
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Zip | 92307-1329
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Country | US
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Telephone | 760-242-0375
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A52860
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | A52860
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License Number State | CA
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