Organization Active NPI

Jeremy Ian Grosser, M.D., Inc.

  • Medical Specialty Clinic/Center
  • Canoga Park, CA
National Provider Identifier
1174702377
Registry record updated Sep 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
A67128 Issued in CA
Legal business name
JEREMY IAN GROSSER, M.D., INC.
Practice address
7355 Topanga Canyon Blvd Ste 200
Canoga Park, CA 91303-1244
Phone
(818) 885-8500
Fax
(818) 700-5690
NPI assigned
Oct 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2022

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

Authorized official

Name
Dr. Jeremy Ian Grosser, MDNPI 1235123373
Title
President
Phone
(818) 929-2259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X A67128 CA Primary

Addresses

Primary practice location

7355 Topanga Canyon Blvd Ste 200
Canoga Park, CA 91303-1244

Mailing address

109 Dapplegray Rd
Bell Canyon, CA 91307-1050
Phone (818) 929-2259

National Provider Directory

National Provider Directory
Tax ID family
Jeremy Ian Grosser MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7355 Topanga Canyon Blvd
Ste 200
Canoga Park, CA 91303
Phone (818) 762-7171

5950 Canoga Ave
Ste 605
Woodland Hls, CA 91367

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662249600000",
    "number": "1174702377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 DAPPLEGRAY RD",
            "city": "BELL CANYON",
            "state": "CA",
            "postal_code": "913071050",
            "telephone_number": "818-929-2259",
            "fax_number": "818-700-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 TOPANGA CANYON BLVD STE 200",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031244",
            "telephone_number": "818-885-8500",
            "fax_number": "818-700-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY IAN GROSSER, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2022-09-04",
        "certification_date": "2022-09-04",
        "status": "A",
        "authorized_official_last_name": "GROSSER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-929-2259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A67128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2022; 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.