Provider Demographics
NPI:1588680060
Name:ROSS, BARRY J (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:J
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1206
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-1206
Mailing Address - Country:US
Mailing Address - Phone:805-569-8922
Mailing Address - Fax:805-563-7671
Practice Address - Street 1:2415 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3819
Practice Address - Country:US
Practice Address - Phone:805-687-7444
Practice Address - Fax:805-687-3707
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA495202081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA250013410OtherRR MEDICARE
CAGR0040970Medicaid
CAWA49520EMedicare PIN
CAWA49520DMedicare PIN
CAW9293AMedicare PIN
CA250013410OtherRR MEDICARE
CAGR0040970Medicaid
CAW9293EMedicare PIN
CAWA49520AMedicare PIN
CAW9293Medicare PIN