| Doctor Name: | BRIAN RONALD GROSS |
| NPI Number: | 1083620066 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | G37513 |
| Business Practice Address: | 27420 Tourney Rd Suite 100 Valencia, CA - 913555601 |
| Business Phone Number: | 6612593937 |
| Business Fax Number: | 6612593904 |
| Mailing Address: | 27420 Tourney Rd, Suite 100 VALENCIA |
| State: | CA |
| Postal Code: | 913555601 |
| Phone Number: | 6612593937 |
| Fax Number: | 6612593904 |
| NPI Enumeration Date: | 07/31/2006 |
| NPI Last Update Date: | 08/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | G37513 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |