Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 2014-01197 | NC |
N | 208600000X | Surgeon | 2014-01197 | NC |
Y | 2086S0120X | Pediatric Surgery | A157157 | CA |
NPI | 1356646590 |
---|---|
Provider Name | Eric Grossman |
First Address | Santa Barbara, CA 93111-2341 |
Second Address | Santa Barbara, CA 93111-2466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2011 |
Last Update Date | 03/11/2021 |