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General NPI Number Information
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NPI Number | 1851580005
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Entity Type | Organization
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Legal Business Name | C ROSS M.D. INC.
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 11755 VICTORY BLVD 240
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City | N HOLLYWOOD
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State | CA
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Zip | 91606-3423
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Country | US
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Telephone | 310-466-0449
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Fax |
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Provider Business Mailing Address
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Address Line | 11755 VICTORY BLVD 240
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City | N HOLLYWOOD
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State | CA
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Zip | 91606-3423
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Country | US
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Telephone | 310-466-0449
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. CURLEE ROSS
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Credential | M.D.
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Telephone | 310-466-0449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | G46021
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A17995
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License Number State | CA
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