DR. KENNETH GARY GROSS


Address: 5222 Balboa Ave, Sixth Floor, San Diego, CA 92117-6904
Phone: 8582925101

DR. KENNETH GARY GROSS (NPI# 1104865898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104865898
Entity Type Individual
Full Name DR. KENNETH GARY GROSS
Credential M.D.
Practice Address 5222 Balboa Ave
Sixth Floor
San Diego
CA 92117-6904
Practice Telephone 8582925101
Practice Fax Number 8582920514
Mailing Telephone 8582925101
Mailing Fax Number 8582920514
Enumeration Date 2006-06-06
Last Update Date 2008-05-05
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology A37440 CA Allopathic & Osteopathic Physicians
N 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
A37440 CA Allopathic & Osteopathic Physicians
N 207NS0135X Dermatology
Specialization: Procedural Dermatology
A37440 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA CA STATE LICENSE A37440 01
CA 00A374400 05

Other Providers KENNETH GROSS

NPI Name Taxonomy Address Enumeration
1528587433 Kenneth Gross Counselor 22765 Westheimer Pkwy, Katy, TX 77450-8675 2017-09-12
1205357886 Kenneth Gross Psychiatry & Neurology 777 S Broad St Apt 412, Philadelphia, PA 19147-2509 2017-07-04
1740488709 Kenneth M Gross Chiropractor 293 Passaic St, Passaic, NJ 07055-5803 2007-07-10
1831155969 Kenneth M Gross Internal Medicine 904 7th Ave, Seattle, WA 98104-1132 2006-04-26
1730155938 Kenneth P Gross Anesthesiology 2900 S 70th St Ste 450, Lincoln, NE 68506-3796 2006-02-27

Office Location

Street Address 5222 BALBOA AVE
SIXTH FLOOR
City SAN DIEGO
State CA
Zip Code 92117-6904

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699772756 Raymond C Heung Internal Medicine 5222 Balboa Ave, Ste 33, San Diego, CA 92117-6953 2005-07-05
1265851810 Lindsay Lindsay Trottier Acupuncturist 5222 Balboa Ave, Suite 21, San Diego, CA 92117-6904 2014-04-10
1427499128 Rty Pharmaceutical Inc Pharmacy 5222 Balboa Ave, San Diego, CA 92117-6904 2013-07-10
1215294244 Erica Dawn Stark Acupuncturist 5222 Balboa Ave, Suite 43, San Diego, CA 92117-6904 2012-04-16
1447563275 Jessica Davis Nurse Practitioner 5222 Balboa Ave, Suite 31, San Diego, CA 92117-6904 2010-07-21
1548441389 Walter Jolley Dpm A Professional Corporation Podiatrist 5222 Balboa Ave, Suite 52, San Diego, CA 92117-6904 2007-11-20
1750570289 Evelyn Jeehyun Kang Chiropractor 5222 Balboa Ave, Suite# 73, San Diego, CA 92117-6904 2007-10-22
1669699849 Raymond Heung, M.d. Clinical Medical Laboratory 5222 Balboa Ave, Suite 33, San Diego, CA 92117-6904 2007-04-19
1538384573 Mike Adams Dentist 5222 Balboa Ave, Suite 71, San Diego, CA 92117-6904 2007-04-16
1194898064 Mahindokht Mary Raiszadeh Legal Medicine 5222 Balboa Ave, Ste 45, San Diego, CA 92117-6904 2006-11-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154956050 Enbara Corporation Dentist 5189 Clairmont Mesa Blvd, San Diego, CA 92117 2020-03-11
1568956050 Lourdes C Villagran Case Manager/Care Coordinator 4474 Charger Blvd, San Diego, CA 92117 2018-06-18
1750893509 Dzendzel Family Chiropractic Chiropractor 3650 Clairemont Drive, Ste 2, San Diego, CA 92117 2017-11-02
1205355401 Alan Ford Counselor 4150 Ute Dr., San Diego, CA 92117 2017-09-19
1780101238 Allison Dawn Heeney Occupational Therapist 3386 Hopi Place, San Diego, CA 92117 2017-08-25
1275074379 Rachel Gabrielle Packer Counselor 5252 Balboa Ave Ste 801, San Diego, CA 92117 2017-03-09
1316482995 Lisa Graff-marsh, Inc. Social Worker 4985 Park Rim Dr., San Diego, CA 92117 2017-01-05
1417408949 Markos and Markos 1 Inc Private Vehicle 4495 Clairemont Mesa Blvd, San Diego, CA 92117 2016-10-19
1801341813 Huynh and Habashi Dental Corporation Dentist 2995 Clairemont Dr, Suite A, San Diego, CA 92117 2016-08-19
1184076077 Tammy Monck Optometrist 3952 Clairemont Mesa Blvd Ste I, San Diego, CA 92117 2016-07-05
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497399141 Dermatology Specialists Inc Dermatology 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 2019-11-05
1306405998 Mismo Dermatology Group Apc Dermatology 8898 Navajo Rd Ste C-349, San Diego, CA 92119-2141 2019-06-07
1609361740 Seaver Soon Md Inc Dermatology 2044 W California St, San Diego, CA 92110-2121 2018-06-29
1700240249 Alexandra Edelman Dermatology 3965 5th Ave Ste 200, San Diego, CA 92103-3107 2016-04-11
1033572391 Lauren Metterle Dermatology 3020 Childrens Way # 5092, San Diego, CA 92123-4223 2016-04-03
1225493323 Jeanette Jacknin Dermatology 12634 Carmel Country Rd, Suite 126, San Diego, CA 92130-3197 2015-12-16
1417330432 Eugene Tachuk Dermatology 3740 Rosecrans St Ste C, San Diego, CA 92110-3126 2015-07-08
1508203563 Monica Boen Dermatology 9339 Genesee Ave Ste 350, San Diego, CA 92121-2150 2013-05-31
1619311164 David Otto Schairer Dermatology 8010 Frost St Ste 602, San Diego, CA 92123 2013-04-25
1295037760 Susan Ann Kincaid Dermatology 1951 4th Ave Ste 202, San Diego, CA 92101-2374 2010-12-03
Find all providers in SAN DIEGO

Competitor

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City SAN DIEGO
Zip Code 92117

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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