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General NPI Number Information
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NPI Number | 1801126958
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Entity Type | Organization
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Legal Business Name | THOMAS GROSCH, MD, APC
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 191 S. BUENA VISTA, SUITE 320
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City | BURBANK
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State | CA
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Zip | 91505-4556
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Country | US
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Telephone | 818-559-9727
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Fax | 818-559-5514
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Provider Business Mailing Address
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Address Line | 191 S. BUENA VISTA, SUITE 320
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City | BURBANK
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State | CA
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Zip | 91505-4556
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Country | US
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Telephone | 818-559-9727
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Fax | 818-559-5514
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS M GROSCH
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Credential | M.D. F.A.C.S.
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Telephone | 818-559-9727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | G82164
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License Number State | CA
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