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General NPI Number Information
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NPI Number | 1538869037
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Entity Type | Organization
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Legal Business Name | DR GROSS MEDICAL CENTER, INC
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 1718 COLORADO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041
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Country | US
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Telephone | 323-561-3006
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Fax | 323-561-3062
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Provider Business Mailing Address
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Address Line | 1718 COLORADO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90041
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Country | US
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Telephone | 323-561-3006
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Fax | 323-561-3062
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Authorized Official
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Title or Position | OWNER /MEDICAL DIRECTOR
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Name | BENJAMIN GROSS
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Credential | MD
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Telephone | 323-561-3006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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