Gross, Kenneth Gary

Gross, Kenneth Gary is an individual health care provider with primary practice located at 5222 Balboa Ave Sixth Floor, San Diego CA 92117-6904. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Gross, Kenneth Gary can be contacted via phone (858) 292-5101.

Contact Information

Primary practice address
5222 Balboa Ave Sixth Floor San Diego CA 92117-6904
Phone: (858) 292-5101
Fax: (858) 292-0514
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X A37440 California
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X A37440 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X A37440 California

Profile Details

NPI number 1104865898
LBN Legal business name Gross, Kenneth Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated May 5th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104865898 NPPES
California MEDICAID 00A374400
California Other A37440

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