Provider Demographics
NPI:1295827830
Name:GROSSMONT SURGICAL ASSOCIATES,INC
Entity Type:Organization
Organization Name:GROSSMONT SURGICAL ASSOCIATES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MUNSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-462-8100
Mailing Address - Street 1:5565 GROSSMONT CENTER DRIVE
Mailing Address - Street 2:SUITE 1-221
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3020
Mailing Address - Country:US
Mailing Address - Phone:619-462-8100
Mailing Address - Fax:619-462-7933
Practice Address - Street 1:5565 GROSSMONT CENTER DRIVE
Practice Address - Street 2:SUITE 1-221
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3020
Practice Address - Country:US
Practice Address - Phone:619-462-8100
Practice Address - Fax:619-462-7933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty