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General NPI Number Information
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NPI Number | 1861590184
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Entity Type | Organization
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Legal Business Name | ALAN MARK GROSS MD, INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 2151 E GONZALES RD #201
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City | OXNARD
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State | CA
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Zip | 93036-3704
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Country | US
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Telephone | 805-988-4097
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Fax | 805-988-2497
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Provider Business Mailing Address
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Address Line | 2151 E GONZALES RD #201
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City | OXNARD
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State | CA
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Zip | 93036-3704
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Country | US
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Telephone | 805-988-4097
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Fax | 805-988-2497
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Authorized Official
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Title or Position | MEDICAL DOCTOR BUSINESS OWNER
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Name | MR. ALAN MARK GROSS
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Credential | MD
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Telephone | 805-988-4097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G047080
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License Number State | CA
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