Provider Demographics
NPI:1003127242
Name:GROVER, CASEY ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:ANDREW
Last Name:GROVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23625 HOLMAN HWY
Mailing Address - Street 2:CHOMP EMERGENCY SERVICES
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5902
Mailing Address - Country:US
Mailing Address - Phone:831-624-5311
Mailing Address - Fax:831-625-4763
Practice Address - Street 1:23625 HOLMAN HWY
Practice Address - Street 2:CHOMP EMERGENCY SERVICES
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5902
Practice Address - Country:US
Practice Address - Phone:831-624-5311
Practice Address - Fax:831-625-4763
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA117699207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program