Provider Demographics
NPI:1598965659
Name:ROSS, GARY STUART (MD)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:STUART
Last Name:ROSS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:500 SUTTER STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:415-398-0555
Mailing Address - Fax:415-398-6228
Practice Address - Street 1:500 SUTTER STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-398-0555
Practice Address - Fax:415-398-6228
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
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Provider Licenses
StateLicense IDTaxonomies
CAG29892208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
A44211Medicare UPIN