Individual provider · Type 1 NPI
Mark Douglas Grove, PA-C
Surgical Physician Assistant · Loma Linda, CA
NPI number
1679306153
Active
Practice location
24785 Stewart St Rm 201
Loma Linda, CA 92350-1721
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | PA65295 (CA) |
| Surgical Physician Assistant Primary | 363AS0400X | PA65295 (CA) |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
Other surgical physician assistant providers in Loma Linda
- Jason L. Roddick, PA-CSurgical Physician Assistant Loma Linda, CA NPI 1164509899
- Peter Paul Peng, PA-CSurgical Physician Assistant Loma Linda, CA NPI 1497421747
- O. Howard Shattuck Jr., P.A.Surgical Physician Assistant Loma Linda, CA NPI 1568569598
- Andrew FelixSurgical Physician Assistant Loma Linda, CA NPI 1851179154
- Leigh Ann Ballou, PA-CSurgical Physician Assistant Loma Linda, CA NPI 1891794657
About NPI 1679306153
Mark Douglas Grove, PA-C's National Provider Identifier is 1679306153, issued on Aug 21, 2024. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Loma Linda, CA. The record was last updated on May 14, 2025.