Individual
BUKOLA GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13010 HESPERIA RD STE 501, VICTORVILLE, CA 92395-8315
(760) 881-3717
Mailing address
19111 TOWN CENTER DR, APPLE VALLEY, CA 92308-8989
(760) 242-7777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP95001547
CA
Other
Enumeration date
10/27/2014
Last updated
11/07/2022
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