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NPI Code Detail

MEDICARE: SANJAY GROVER MD

MEDICARE:   SANJAY  GROVER  MD
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
1208200000XPlastic Surgery PhysicianA54558CA

General Provider Information

NPI Number : 1982776852
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANJAY GROVER MD
Provider Business Mailing Address
First Line : 20360 SW BIRCH ST STE 120
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-1532
Country : US
Telephone Number : 949-759-9551
Fax Number : 949-706-5624
Provider Business Practice Location Address
First Line : 20360 SW BIRCH ST STE 120
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-1532
Country : US
Telephone Number : 949-759-9551
Fax Number : 949-706-5624
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 01/25/2022

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