Organization
BRIAN R GROSS,MD,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN RONALD GROSS MD (OWNER/MD)
(661) 255-6622
Entity
Organization
Contact information
Practice address
25880 TOURNAMENT RD, SUITE 109, VALENCIA, CA 91355-2349
(661) 255-6622
(661) 255-6628
Mailing address
25880 TOURNAMENT RD, SUITE 109, VALENCIA, CA 91355-2349
(661) 255-6622
(661) 255-6628
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
156FX1100X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2998318
—
CA
Enumeration date
04/18/2008
Last updated
04/18/2008
Update your record
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