Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G47590 | CA |
NPI | 1215940911 |
---|---|
Provider Name | Michael G Ross |
First Address | Torrance, CA 90502-2047 |
Second Address | Torrance, CA 90502-2047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 06/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G475900 | (05) | CA |
A92733 | (02) | CA |