Provider Demographics
NPI:1801126958
Name:THOMAS GROSCH, MD, APC
Entity type:Organization
Organization Name:THOMAS GROSCH, MD, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:GROSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS
Authorized Official - Phone:818-559-9727
Mailing Address - Street 1:191 S. BUENA VISTA, SUITE 320
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4556
Mailing Address - Country:US
Mailing Address - Phone:818-559-9727
Mailing Address - Fax:818-559-5514
Practice Address - Street 1:191 S. BUENA VISTA, SUITE 320
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4556
Practice Address - Country:US
Practice Address - Phone:818-559-9727
Practice Address - Fax:818-559-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82164207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty