Healthcare Provider Details

I. General information

NPI: 1588680060
Provider Name (Legal Business Name): BARRY J ROSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 06/11/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 DE LA VINA ST
SANTA BARBARA CA
93105-3819
US

IV. Provider business mailing address

PO BOX 1206
GOLETA CA
93116-1206
US

V. Phone/Fax

Practice location:
  • Phone: 805-687-7444
  • Fax: 805-687-3707
Mailing address:
  • Phone: 805-569-8922
  • Fax: 805-563-7671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA49520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: