Provider Demographics
NPI:1891994778
Name:GROVER, SARV MITTAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SARV
Middle Name:MITTAR
Last Name:GROVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SAINT ROBERT
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-4133
Mailing Address - Country:US
Mailing Address - Phone:951-273-2928
Mailing Address - Fax:951-273-2318
Practice Address - Street 1:2 SAINT ROBERT
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-4133
Practice Address - Country:US
Practice Address - Phone:951-273-2928
Practice Address - Fax:951-273-2318
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine