Provider Demographics
NPI:1194043117
Name:ROSS, BARBARA J (DC)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:J
Last Name:ROSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3920 WILLIAMS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-2745
Mailing Address - Country:US
Mailing Address - Phone:408-243-8300
Mailing Address - Fax:
Practice Address - Street 1:3920 WILLIAMS RD
Practice Address - Street 2:SUITE B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-2745
Practice Address - Country:US
Practice Address - Phone:408-243-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15370111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0153700Medicare PIN