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NPI Code Detail

MEDICARE: ALESSANDRA AMY ELIZABETH ROSS MD

MEDICARE: ALESSANDRA AMY ELIZABETH ROSS MD
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
1207X00000XOrthopaedic Surgery Physician0101236659VA
2207X00000XOrthopaedic Surgery Physician128009CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A128009OTHERCACA MEDICAL LICENSE
212652821OTHERCACAQH

General Provider Information

NPI Number : 1275643199
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALESSANDRA AMY ELIZABETH ROSS MD
Provider Business Mailing Address
First Line : 1225 MARSHALL ST
Second Line : STE 7
City : CRESCENT CITY
State : CA
Zip : 95531-2281
Country : US
Telephone Number : 707-464-1989
Fax Number : 707-464-9593
Provider Business Practice Location Address
First Line : 3770 JANES RD
Second Line :
City : ARCATA
State : CA
Zip : 95521-4744
Country : US
Telephone Number : 707-826-7846
Fax Number : 707-826-7845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 09/16/2015

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