Individual provider Active NPI

Glenn Mark Grossman, M.D.

  • Obstetrics & Gynecology Physician
  • Mission Hills, CA
National Provider Identifier
1063693000
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G74125 Issued in CA
Practice address
11600 Indian Hills Rd
Suite 200
Mission Hills, CA 91345-1225
Phone
(818) 838-4500
NPI assigned
Nov 19, 2007
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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 G74125 CA Primary

Addresses

Primary practice location

11600 Indian Hills Rd
Suite 200
Mission Hills, CA 91345-1225

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512001665 CA Practitioner - Obstetrics/Gynecology 9234129222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11600 Indian Hills Rd
Mission Hills, CA 91345-1225
Phone (818) 838-4500

18546 Roscoe Blvd
Suite 300
Northridge, CA 91324-5458
Phone (818) 886-4028

824 E Carson St
Suite 104
Carson, CA 90745-2262
Phone (310) 830-9706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74125CAMDPharmacist
G74125CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Jun 12, 2020 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 1, 2001 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 1, 2001 Accepting new patients
West Hills Hospital Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Dignity Community Care Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Providence Facey Medical Foundation Obstetrics & Gynecology Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

11600 Indian Hills Rd
Mission Hills, CA 91345
Phone (818) 781-7097

11600 Indian Hills Rd
Ste 200
Mission Hills, CA 91345
Phone (818) 838-4500

18300 Roscoe Blvd
Northridge, CA 91325
Phone (818) 885-5331

18546 Roscoe Blvd
Ste 300
Northridge, CA 91324
Phone (818) 341-4796

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

7325 Medical Ctr
Ste 300
West Hills, CA 91307
Phone (818) 226-3666

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: glenngrossman@hcpca.allscriptsdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1063693000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 INDIAN HILLS RD",
            "address_2": "SUITE 200",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451225",
            "telephone_number": "818-838-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "GLENN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G74125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.