Provider Demographics
NPI:1467586255
Name:ROSS, CRAIG S (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:S
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 1:6700 FALLBROOK AVE
Mailing Address - Street 2:170
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3530
Mailing Address - Country:US
Mailing Address - Phone:818-515-9685
Mailing Address - Fax:818-337-7152
Practice Address - Street 1:6700 FALLBROOK AVE
Practice Address - Street 2:170
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-3530
Practice Address - Country:US
Practice Address - Phone:818-515-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16838111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor