Provider Demographics
NPI:1083743520
Name:ROSS, CALVIN BELNAP (DC)
Entity Type:Individual
Prefix:MR
First Name:CALVIN
Middle Name:BELNAP
Last Name:ROSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31882 DEL OBISPO
Mailing Address - Street 2:SUITE 158
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675
Mailing Address - Country:US
Mailing Address - Phone:949-661-9476
Mailing Address - Fax:949-661-7536
Practice Address - Street 1:31882 DEL OBISPO ST
Practice Address - Street 2:SUITE 158
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3225
Practice Address - Country:US
Practice Address - Phone:949-661-9476
Practice Address - Fax:949-661-7536
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15026111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition