Provider Demographics
NPI:1013093426
Name:ROSS, MICHELE KAY (DC LAC)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:KAY
Last Name:ROSS
Suffix:
Gender:F
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4907 MORENA BLVD #1406
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117
Mailing Address - Country:US
Mailing Address - Phone:858-270-8085
Mailing Address - Fax:858-270-8093
Practice Address - Street 1:4907 MORENA BLVD #1406
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117
Practice Address - Country:US
Practice Address - Phone:858-270-8085
Practice Address - Fax:858-270-8093
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18617111N00000X
CAAC6837171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist