Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | A81792 | CA |
NPI | 1053434985 |
---|---|
Provider Name | Dr. Dawn Michelle Gross |
First Address | Laguna Hills, CA 92653-1313 |
Second Address | Newark, CA 94560-5355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2007 |
Last Update Date | 15/09/2015 |