MR. MARK DOUGLAS GROVE PA-C
NPI 1679306153
Physician Assistant - Surgical in Loma Linda, CA
About Mr. Mark Douglas Grove Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MARK DOUGLAS GROVE PA-C (NPI 1679306153) is an individual surgical provider in Loma Linda, California, licensed in California (PA65295) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Mark Douglas Grove Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mark Grove's NPI number?
The NPI number for Mark Grove is 1679306153. It was assigned to this individual provider in the NPPES registry on August 21, 2024.
Where is Mark Grove located?
Mark Grove practices at 24785 Stewart St Rm 201, Loma Linda, CA 92350. The listed phone number is (909) 558-8161.
What is Mark Grove's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Mark Grove enrolled in Medicare?
Yes. Mark Grove is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Mark Grove was last updated on May 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Mark Douglas Grove, PA-C · NPI 1679306153
Surgical physician in Loma Linda, California. Individual provider, active in the CMS NPPES registry since August 21, 2024.
## Identity
- **NPI:** 1679306153 (Entity type: Individual)
- **Enumerated:** August 21, 2024
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** PA65295 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 24785 STEWART ST RM 201, Loma Linda, CA 92350-1721
- **Phone:** (909) 558-8161
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for durable medical equipment, power mobility devices
## Record status
- **NPPES last updated:** May 14, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1679306153) · Data from the CMS NPPES public registry.