MEDICARE: DR. MICHELE KAY ROSS DC LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	18617	CA
2	171100000X	Acupuncturist	AC6837	CA

General Provider Information

NPI Number	:	1013093426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE KAY ROSS DC LAC

Provider Business Mailing Address
First Line	:	4907 MORENA BLVD #1406
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117
Country	:	US
Telephone Number	:	858-270-8085
Fax Number	:	858-270-8093

Provider Business Practice Location Address
First Line	:	4907 MORENA BLVD #1406
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117
Country	:	US
Telephone Number	:	858-270-8085
Fax Number	:	858-270-8093

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	09/11/2025

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