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General NPI Number Information
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NPI Number | 1902828007
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Entity Type | Individual
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Provider Name | MICHAEL J GROTH MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 9675 BRIGHTON WAY SUITE 410
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5192
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Country | US
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Telephone | 310-274-2525
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Fax | 310-274-5530
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Provider Business Mailing Address
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Address Line | 9675 BRIGHTON WAY SUITE 410
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-5192
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Country | US
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Telephone | 310-274-2525
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Fax | 310-274-5530
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G58694
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | G58694
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License Number State | CA
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