Healthcare Provider Details

I. General information

NPI: 1598607095
Provider Name (Legal Business Name): BRANDI ROSS CALI PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70799 JASMINE LN
RANCHO MIRAGE CA
92270-2317
US

IV. Provider business mailing address

70799 JASMINE LN
RANCHO MIRAGE CA
92270-2317
US

V. Phone/Fax

Practice location:
  • Phone: 219-561-6303
  • Fax:
Mailing address:
  • Phone: 219-561-6303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BRANDI ROSS-DOUGLAS
Title or Position: OWNER
Credential: MD
Phone: 219-561-6303