Individual
DR. JAY R. GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3629 VISTA WAY, OCEANSIDE, CA 92056-4522
(760) 828-9200
(760) 828-9141
Mailing address
3629 VISTA WAY, OCEANSIDE, CA 92056-4522
(760) 828-9200
(760) 828-9141
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G27789
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070003595
RAILROAD MEDICARE
CA
Enumeration date
06/09/2006
Last updated
12/01/2008
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