Skin Surgery Medical Group Inc.

LBN: Skin Surgery Medical Group Inc.
Skin Surgery Medical Group Inc. is an health care organization with primary practice located at 5222 Balboa Ave Sixth Floor, San Diego CA 92117-6904. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Skin Surgery Medical Group Inc. can be contacted via phone (858) 292-5101, or through Gross, Kenneth Gary via phone (858) 292-5101.

Contact Information

Primary practice address
5222 Balboa Ave Sixth Floor San Diego CA 92117-6904
Phone: (858) 292-5101
Fax: (858) 292-0514
Website:
Map and Directions
Authorized official contact:
Name: Gross, Kenneth Gary Doctor of Medicine (MD)
Phone: (858) 292-5101

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X California

Profile Details

NPI number 1659326957
LBN Legal business name Skin Surgery Medical Group Inc.
DBA Doing business as
Authorized official Gross, Kenneth Gary Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 24th, 2006
Last updated May 5th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659326957 NPPES
California MEDICAID GR0069330

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