Basic Information
| Provider Information | |||||||||
| NPI: | 1891994778 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GROVER | ||||||||
| FirstName: | SARV | ||||||||
| MiddleName: | MITTAR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 SAINT ROBERT | ||||||||
| Address2: | |||||||||
| City: | DANA POINT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926294133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512732928 | ||||||||
| FaxNumber: | 9512732318 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 SAINT ROBERT | ||||||||
| Address2: | |||||||||
| City: | DANA POINT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926294133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9512732928 | ||||||||
| FaxNumber: | 9512732318 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2007 | ||||||||
| LastUpdateDate: | 07/12/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A36518 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.