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NPI Code Detail

MEDICARE: MR. MICHAEL L. ROSS MBA, R.PH.

MEDICARE: MR. MICHAEL L. ROSS MBA, R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1300XPsychiatric Pharmacist26968CA

General Provider Information

NPI Number : 1073511390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL L. ROSS MBA, R.PH.
Provider Business Mailing Address
First Line : 4734 SUNBURST RD
Second Line :
City : CARLSBAD
State : CA
Zip : 92008-3656
Country : US
Telephone Number : 760-729-1745
Fax Number : 760-729-4123
Provider Business Practice Location Address
First Line : 11878 AVENUE OF INDUSTRY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-3423
Country : US
Telephone Number : 858-675-4259
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 07/08/2007

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