Individual provider Active NPI

Jeotsna Grover, MD

  • Obstetrics & Gynecology Physician
  • Sylmar, CA
National Provider Identifier
1386757680
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A43590 Issued in CA
Practice address
14445 Olive View Dr
Room #3A101 Olive View UCLA Medical Center
Sylmar, CA 91342-1495
Phone
(818) 364-4349
Fax
(818) 364-3292
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 A43590 CA Primary

Addresses

Primary practice location

14445 Olive View Dr
Room #3A101 Olive View UCLA Medical Center
Sylmar, CA 91342-1495

Mailing address

14445 Olive View Dr
Room #3A101 Olive View UCLA Medical Center
Sylmar, CA 91342-1495
Phone (818) 364-4349

Other identifiers 1

IdentifierTypeStateIssuer
00A435900MedicaidCA

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
A43590CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Hospitals Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386757680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "ROOM #3A101 OLIVE VIEW UCLA MEDICAL CENTER",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421495",
            "telephone_number": "818-364-4349",
            "fax_number": "818-364-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "address_2": "ROOM #3A101 OLIVE VIEW UCLA MEDICAL CENTER",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421495",
            "telephone_number": "818-364-4349",
            "fax_number": "818-364-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "JEOTSNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A43590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A435900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.