MEDICARE: DR. HOWARD MICHAEL GROSS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G061854	CA
2	208200000X	Plastic Surgery Physician	G61854	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467458273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD MICHAEL GROSS M.D.

Provider Business Mailing Address
First Line	:	1722 STATE STREET
Second Line	:	SUITE 201
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101
Country	:	US
Telephone Number	:	805-898-2600
Fax Number	:	805-898-2604

Provider Business Practice Location Address
First Line	:	1722 STATE STREET
Second Line	:	SUITE 201
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101
Country	:	US
Telephone Number	:	805-898-2600
Fax Number	:	805-898-2604

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	09/04/2014

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