Healthcare Provider Details

I. General information

NPI: 1316237548
Provider Name (Legal Business Name): ELSIE GYANG ROSS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELSIE GYANG

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR
SAN DIEGO CA
92103-9000
US

IV. Provider business mailing address

FILE 57326
LOS ANGELES CA
90074-7326
US

V. Phone/Fax

Practice location:
  • Phone: 800-926-8273
  • Fax: 888-539-8781
Mailing address:
  • Phone: 800-926-8273
  • Fax: 888-539-8781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA122005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: