Provider Demographics
NPI:1861628828
Name:ROSS, MINDY K (MD)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:K
Last Name:ROSS
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:MDCC 22-387
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095
Mailing Address - Country:US
Mailing Address - Phone:310-825-5930
Mailing Address - Fax:310-794-7338
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:MDCC 22-387
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-825-5930
Practice Address - Fax:310-794-7338
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2018-12-06
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Provider Licenses
StateLicense IDTaxonomies
CAA99914208000000X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics