Provider Demographics
NPI:1578839189
Name:BROSS AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:BROSS AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-521-1112
Mailing Address - Street 1:3604 CALLE CANON
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3036
Mailing Address - Country:US
Mailing Address - Phone:818-521-1112
Mailing Address - Fax:818-222-6888
Practice Address - Street 1:450 N BRAND BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2347
Practice Address - Country:US
Practice Address - Phone:818-521-1112
Practice Address - Fax:818-222-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier