Provider Demographics
NPI:1598957086
Name:ROSS, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:628 W MICHELTORENA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-4131
Mailing Address - Country:US
Mailing Address - Phone:805-968-1511
Mailing Address - Fax:805-685-2467
Practice Address - Street 1:628 W MICHELTORENA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-4131
Practice Address - Country:US
Practice Address - Phone:805-968-1511
Practice Address - Fax:805-685-2467
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAGG20577208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG20577OtherSTATE LICENSE
CAAR5768037OtherDEA