Healthcare Provider Details

I. General information

NPI: 1558364836
Provider Name (Legal Business Name): STEVEN DOUGLAS ROSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR. SOUTH PAVILION LLL
ORANGE CA
92868
US

IV. Provider business mailing address

101 THE CITY DR. SOUTH PAVILION LLL
ORANGE CA
92868
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5759
  • Fax: 714-456-7547
Mailing address:
  • Phone: 714-456-5759
  • Fax: 714-456-7547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG37046
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: