Provider Demographics
NPI:1407961188
Name:GROSS, JEFFREY D (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27882 FORBES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1219
Mailing Address - Country:US
Mailing Address - Phone:949-364-6888
Mailing Address - Fax:949-364-6333
Practice Address - Street 1:27882 FORBES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1219
Practice Address - Country:US
Practice Address - Phone:949-364-6888
Practice Address - Fax:949-364-6333
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG79394207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery