Healthcare Provider Details

I. General information

NPI: 1851303044
Provider Name (Legal Business Name): DAVID ROSS OSTRANDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 HEALTH CENTER DR
SAN DIEGO CA
92123-2762
US

IV. Provider business mailing address

2929 HEALTH CENTER DR
SAN DIEGO CA
92123-2762
US

V. Phone/Fax

Practice location:
  • Phone: 858-939-6561
  • Fax: 858-874-2379
Mailing address:
  • Phone: 858-939-6561
  • Fax: 858-874-2379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG36558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: