Provider Demographics
NPI:1831200591
Name:GROSZ, DANIEL ESTEBAN (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ESTEBAN
Last Name:GROSZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:E
Other - Last Name:GROSZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:16661 VENTURA BLVD
Mailing Address - Street 2:SUITE 603
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-386-0500
Mailing Address - Fax:818-386-2019
Practice Address - Street 1:16661 VENTURA BLVD
Practice Address - Street 2:SUITE 603
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-386-0500
Practice Address - Fax:818-386-2019
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA497722084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F33002Medicare UPIN