Organization
JAY GROSS, M.D., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL GRACIA (OFFICE MANAGER)
(310) 496-3770
Entity
Organization
Contact information
Practice address
2222 SANTA MONICA BLVD, SUITE 107, SANTA MONICA, CA 90404-2304
(310) 496-3770
(310) 496-3767
Mailing address
2222 SANTA MONICA BLVD, SUITE 107, SANTA MONICA, CA 90404-2304
(310) 496-3770
(310) 496-3767
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G36307
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G373070
—
CA
Enumeration date
10/02/2008
Last updated
10/17/2012
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