Keith Mark Gross MD Inc
NPI 1871658278ActiveOrganization· Dermatology· Victorville, CA
Dermatology in Victorville, California, registered in NPPES in December 2006. The authorized official on file is Keith Gross, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1871658278 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 26, 2006 |
| Last updated in NPPES | Jan 17, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | G63544 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ); Part B Supplier - Clinic/Group Practice (CA); Part B Supplier - Clinic/Group Practice (NV) |
|---|
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