Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyle Grgich

Individual provider Physician Assistant · NPI 1972018745

Kyle Grgich is a Physician Assistant in Loma Linda, California. Qualified in 2017, 9 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2017
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Practice location Address checks out

11234 Anderson St
Loma Linda, CA 92354-2804
Phone: (909) 558-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 55189 (CA)

Record details

NPI number1972018745
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 2, 2017
Last updated in NPPESNovember 2, 2021
Certification dateNovember 2, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Loma Linda