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General NPI Number Information
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NPI Number | 1992697684
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Entity Type | Individual
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Provider Name | ARTHUR D GRONEMAN
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Gender | Male
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 892 27TH ST
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City | SAN DIEGO
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State | CA
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Zip | 92154-1444
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Country | US
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Telephone | 619-575-4687
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Fax |
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Provider Business Mailing Address
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Address Line | 1202 MORENA BLVD STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92110-3842
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Country | US
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Telephone | 619-275-0822
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-FTXJRQ
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License Number State | CA
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