Healthcare Provider Details

I. General information

NPI: 1104969625
Provider Name (Legal Business Name): ELIZABETH BETSY GROSS PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N LE DOUX RD
BEVERLY HILLS CA
90211-2210
US

IV. Provider business mailing address

147 N LE DOUX RD
BEVERLY HILLS CA
90211-2210
US

V. Phone/Fax

Practice location:
  • Phone: 310-968-6121
  • Fax: 310-652-4901
Mailing address:
  • Phone: 310-968-6121
  • Fax: 310-652-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH38198
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberRPH38198
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: