Provider Demographics
NPI:1972581627
Name:ROSS, ARNOLD S (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:S
Last Name:ROSS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1990 WESTWOOD BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4674
Mailing Address - Country:US
Mailing Address - Phone:310-475-5377
Mailing Address - Fax:310-446-1825
Practice Address - Street 1:1990 WESTWOOD BLVD STE 220
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4674
Practice Address - Country:US
Practice Address - Phone:310-475-5377
Practice Address - Fax:310-446-1825
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2496213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E24961OtherBLUE SHIELD
CA5976019Medicaid
CA0901300001OtherDMERC
CA8999997002OtherGHI
E2496Medicare PIN
CA8999997002OtherGHI
CAT11359Medicare UPIN
CA000E24961OtherBLUE SHIELD
CA0901300001Medicare NSC