Provider Demographics
NPI:1558303099
Name:GROSMAN, HELENE (RPH)
Entity type:Individual
Prefix:
First Name:HELENE
Middle Name:
Last Name:GROSMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22647 VENTURA BLVD
Mailing Address - Street 2:237
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1416
Mailing Address - Country:US
Mailing Address - Phone:818-704-5121
Mailing Address - Fax:
Practice Address - Street 1:20300 VENTURA BLVD
Practice Address - Street 2:SUITE 245
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2448
Practice Address - Country:US
Practice Address - Phone:818-704-5121
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314531835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition Support