DR. KENNETH GARY GROSS M.D. NPI 1104865898

NPI Information

  • NPI: 1104865898
  • Provider Name: DR. KENNETH GARY GROSS, M.D.
  • Classification: Dermatology - 207N00000X
  • Entity Type: Individual
  • Address: 5222 BALBOA AVE
    SIXTH FLOOR
    SAN DIEGO, CA
    ZIP 92117
  • Phone: (858) 292-5101

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NPI Details

DR. Kenneth Gary Gross, M.D. is a dermatology in San Diego, CA. The provider is 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. DR. Kenneth Gary Gross, M.D. NPI is 1104865898. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5222 BALBOA AVE
SIXTH FLOOR
SAN DIEGO, CA
ZIP 92117-904
Phone: (858) 292-5101
Fax: (858) 292-0514

The enumeration date for this NPI number is 6/6/2006 and was last updated on 5/5/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0101XDermatologyMOHS-Micrographic SurgeryA37440CALIFORNIANo
2207NS0135XDermatologyProcedural DermatologyA37440CALIFORNIANo
3207N00000XDermatologyA37440CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A37440OTHERCALIFORNIACA STATE LICENSE
200A374400MEDICAIDCALIFORNIA
3A28378MEDICARE UPINCALIFORNIA
4WA37440AMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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