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

Mr. Mark Douglas Grove, PA-C

Individual provider Physician Assistant · NPI 1679306153

Mr. Mark Douglas Grove, PA-C is a Physician Assistant in Loma Linda, California. Licensed in California. Registered with an NPI since 2024.

Licensed in
CA
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

24785 Stewart St Rm 201
Loma Linda, CA 92350-1721
Phone: (909) 558-8161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA65295 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA65295 (CA)

Record details

NPI number1679306153
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 21, 2024
Last updated in NPPESMay 14, 2025
Certification dateMay 14, 2025

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