Provider Demographics
NPI:1851358386
Name:ROSS, WILLIAM DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DONALD
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12831 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2632
Mailing Address - Country:US
Mailing Address - Phone:714-892-1520
Mailing Address - Fax:562-627-5640
Practice Address - Street 1:6226 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1423
Practice Address - Country:US
Practice Address - Phone:562-420-1338
Practice Address - Fax:562-627-5640
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-11-05
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Provider Licenses
StateLicense IDTaxonomies
CAG45746207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA05167Medicare UPIN