Healthcare Provider Details

I. General information

NPI: 1265581037
Provider Name (Legal Business Name): ROSS TALARICO D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 BROADWAY
OAKLAND CA
94611-5717
US

IV. Provider business mailing address

PO BOX 31396
WALNUT CREEK CA
94598-8396
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-8585
  • Fax:
Mailing address:
  • Phone: 925-939-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: