Healthcare Provider Details

I. General information

NPI: 1952362915
Provider Name (Legal Business Name): GILBERT NEIL ROSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 WEST ALAMEDA AVENUE SUITE 518
BURBANK CA
91505
US

IV. Provider business mailing address

2625 WEST ALAMEDA AVENUE SUITE 518
BURBANK CA
91505
US

V. Phone/Fax

Practice location:
  • Phone: 818-557-5556
  • Fax: 818-955-8694
Mailing address:
  • Phone: 818-557-5556
  • Fax: 818-955-8694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG19408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: