Provider Demographics
NPI:1891887907
Name:ROSS, SHERYL ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:ANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SANTA MONICA BLVD
Mailing Address - Street 2:#970-W
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2199
Mailing Address - Country:US
Mailing Address - Phone:310-829-7878
Mailing Address - Fax:310-453-5586
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 970W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2199
Practice Address - Country:US
Practice Address - Phone:310-829-7878
Practice Address - Fax:310-453-5586
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG068399174400000X
CAG68399207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF28825Medicare UPIN