Individual provider Active NPI

Kenneth Grolle, MD

  • Obstetrics & Gynecology Physician
  • Sunnyvale, CA
National Provider Identifier
1053416875
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G51767 Issued in CA
Practice address
877 W Fremont Ave
Suite N
Sunnyvale, CA 94087-2315
Phone
(408) 730-4240
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G51767 CA Primary

Addresses

Primary practice location

877 W Fremont Ave
Suite N
Sunnyvale, CA 94087-2315

Mailing address

2350 W El Camino Real
2ND Floor
Mountain View, CA 94040-6201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G51767CAMDObstetrics & Gynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1053416875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 W FREMONT AVE",
            "address_2": "SUITE N",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872315",
            "telephone_number": "408-730-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROLLE",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G51767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.