MEDICARE: DR. MARGARET L. GROSSMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G55960	CA

General Provider Information

NPI Number	:	1942352075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARET L. GROSSMAN M.D.

Provider Business Mailing Address
First Line	:	2778 BUTTERMILK LN
Second Line	:
City	:	ARCATA
State	:	CA
Zip	:	95521-6937
Country	:	US
Telephone Number	:	707-826-2819
Fax Number	:

Provider Business Practice Location Address
First Line	:	4677 VALLEY EAST BLVD STE 1
Second Line	:
City	:	ARCATA
State	:	CA
Zip	:	95521-4630
Country	:	US
Telephone Number	:	707-822-1122
Fax Number	:	707-822-1140

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	02/12/2025

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