Brian R Gross,MD,Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

156FX1100X Issued in CA

Legal business name

BRIAN R GROSS,MD,INC.

Practice address

25880 Tournament Rd
Suite 109
Valencia, CA 91355-2349

Phone

(661) 255-6622

Fax

(661) 255-6628

NPI assigned

Apr 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brian Ronald Gross, MD

Title

Owner/MD

Phone

(661) 255-6622

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1366616476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25880 TOURNAMENT RD",
            "address_2": "SUITE 109",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552349",
            "telephone_number": "661-255-6622",
            "fax_number": "661-255-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25880 TOURNAMENT RD",
            "address_2": "SUITE 109",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552349",
            "telephone_number": "661-255-6622",
            "fax_number": "661-255-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN R GROSS,MD,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "661-255-6622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CA",
            "license": "156FX1100X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2998318",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Valencia, CA
• Providers in Valencia, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.