Michael Jack Grossman, M.D., Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MICHAEL JACK GROSSMAN, M.D., INC

Practice address

4440 Von Karman Ave
Suite 201
Newport Beach, CA 92660

Phone

(949) 222-0232

Fax

(949) 222-0344

NPI assigned

Apr 1, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Michael Jack Grossman, M.D.NPI 1942367008

Title

Owner

Phone

(949) 222-0232

Specialties & licenses 1

Addresses

Other names 1

• BodyLogicMD of Irvine Doing business as

Locations

Practitioners 3

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

• Michael Jack Grossman, M.D.

  • Family Medicine Physician
  • Lake Forest, CA
  • NPI 1942367008
  NPD (past) Authorized official
• Barbara Robinson Grossman, PH.D.

  • Marriage & Family Therapist
  • Newport Beach, CA
  • NPI 1992724470
  NPD
• Nicole A Garcia, M.D.

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1437145505
  NPD (past)

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1952543316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 VON KARMAN AVE",
            "address_2": "SUITE 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-222-0232",
            "fax_number": "949-222-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 VON KARMAN AVE",
            "address_2": "SUITE 201",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-222-0232",
            "fax_number": "949-222-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL JACK GROSSMAN, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-222-0232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BodyLogicMD of Irvine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BodyLogicMD of Irvine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Michael Wesley Summerlin PHD Ek Psych

• Family Medicine Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.