Organization Active NPI

Tiffany B Grunwald, MD, Inc.

  • Plastic and Reconstructive Surgery Physician
  • Santa Monica, CA
National Provider Identifier
1497946594
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
TIFFANY B GRUNWALD, MD, INC.
Practice address
1301 20TH St
Suite 430
Santa Monica, CA 90404-2050
Phone
(310) 828-4646
Fax
(310) 828-3939
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Authorized official

Name
Tiffany B Grunwald, M.D.
Title
President
Phone
(310) 828-4646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

1301 20TH St
Suite 430
Santa Monica, CA 90404-2050

Mailing address

1301 20TH St
Suite 430
Santa Monica, CA 90404-2050
Phone (310) 828-4646

National Provider Directory

National Provider Directory

Locations

1301 20th St
Ste 430
Santa Monica, CA 90404
Phone (310) 828-4646

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1497946594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 20TH ST",
            "address_2": "SUITE 430",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042050",
            "telephone_number": "310-828-4646",
            "fax_number": "310-828-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST",
            "address_2": "SUITE 430",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042050",
            "telephone_number": "310-828-4646",
            "fax_number": "310-828-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFFANY B GRUNWALD, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "GRUNWALD",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-828-4646",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.