Basic Information
| Provider Information | |||||||||
| NPI: | 1053434985 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GROSS | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | MICHELLE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23181 VERDUGO DR 103A | ||||||||
| Address2: | |||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926531313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493661053 | ||||||||
| FaxNumber: | 9499167710 | ||||||||
| Practice Location | |||||||||
| Address1: | 39899 BALENTINE DR | ||||||||
| Address2: | SUITE 161 | ||||||||
| City: | NEWARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945605355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5104389602 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2007 | ||||||||
| LastUpdateDate: | 09/15/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0000X | A81792 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology |
No ID Information.