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General NPI Number Information
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NPI Number | 1184708554
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Entity Type | Individual
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Provider Name | MELVYN B ROSS M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 400 N PEPPER AVE
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City | COLTON
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State | CA
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Zip | 92324-1801
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Country | US
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Telephone | 909-522-2718
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Fax | 909-580-6257
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Provider Business Mailing Address
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Address Line | PO BOX 1632
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City | COLTON
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State | CA
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Zip | 92324-0851
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Country | US
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Telephone | 909-522-2718
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Fax | 909-580-6257
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 00G341000
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License Number State | CA
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