Marco Fulvio Grossi, PT, DPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT299659 Issued in CA

Practice address

3809 Plaza Dr
Ste 112
Oceanside, CA 92056-4625

Phone

(760) 941-2630

NPI assigned

Mar 1, 2021

Last updated

Mar 1, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1174118228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 PLAZA DR",
            "address_2": "STE 112",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92056",
            "telephone_number": "760-941-2630",
            "fax_number": "760-941-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 PLAZA DR",
            "address_2": "STE 112",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564625",
            "telephone_number": "760-941-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSI",
        "first_name": "MARCO",
        "middle_name": "FULVIO",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT299659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "299659",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Individual",
            "affiliation": "N",
            "endpointDescription": "Individual",
            "address_1": "3809 Plaza Dr Ste 112",
            "city": "Oceanside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920564625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tammy G Grinde, DC
• Erin Gritzen
• Liana Groel, M.S., A.T.C.
• Daniel J Gross, PT
• Dustin Grossheim
• Jay R. Grossman, MD
• James Norman Groth, MD
• Kieran Grow
• Brenda L Guadalupe, LMFT
• Karly Grace Gudykunst, OTR

• Specialist in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.