Susan K Grenz, MD
Individual provider Active NPI Internal Medicine Physician · Laguna Woods, CA
NPI 1013989870 · NPPES record last updated Dec 16, 2013
Key facts
- NPI
- 1013989870
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 18697 (MT)
- Practice address
- 779 C Via Los Altos
Laguna Woods, CA 92637 - Phone
- (727) 798-6640
- NPI assigned
- Feb 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18697 | MT | MD | Internal Medicine Physician |
| 12279 | ND | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Care Services Company | Past | Accepting new patients | |
| Kayenta Alternative Rural Hospital | Past | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Susan K Grenz MD PA | Internal Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 18697 | MT | Yes |
| Internal Medicine Physician | 207R00000X | 12279 | ND |
Addresses
Primary practice location
779 C Via Los Altos
Laguna Woods, CA 92637
Mailing address
779 Via Los Altos Unit C
Laguna Woods, CA 92637-4828
Phone (727) 798-6640
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102600 | Other | AUMED | |
| 123062 | Other | HUMANA | |
| 3000067 | Other | BAYCARE | |
| 622728 | Other | AETNA | |
| 3386236002 | Other | CIGNA | |
| 123063 | Other | HUMANA GOLD | |
| 62527 | Other | BCBS | |
| 592712571 | Other | UNITED HEALTH CARE |
Other providers in Laguna Woods, CA
- Evan Goldman
- Michael Mark Goldman
- Ruth L. Goldman
- David Jr Gonzalez
- Scott Michael Graham
- Dimitri Gruer
- Hamarock Consultants Inc
- Kelly A Hanks
- Hanmaum Medical Center
- Douglas Dean Harmon
All providers in Laguna Woods, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.