GRS Medical Group Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A32356 Issued in CA

Legal business name

GRS MEDICAL GROUP INC

Practice address

10745 Riverside Dr
Ste a
Toluca Lake, CA 91602-2371

Phone

(181) 862-3004

NPI assigned

Oct 6, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Ruben Suzon Gualberto, M.D.

Title

Ceo

Phone

(818) 623-0042

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1972838142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10745 RIVERSIDE DR",
            "address_2": "STE A",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022371",
            "telephone_number": "181-862-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10745 RIVERSIDE DR",
            "address_2": "STE A",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022371",
            "telephone_number": "181-862-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "GUALBERTO",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_middle_name": "SUZON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "18186230042",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A32356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Toluca Lake, CA
• Providers in Toluca Lake, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; 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.