Provider Demographics
NPI:1801994975
Name:ROSS, ALLAN SUTHERLAND (DC)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:SUTHERLAND
Last Name:ROSS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 SUNRISE AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4583
Mailing Address - Country:US
Mailing Address - Phone:916-786-6055
Mailing Address - Fax:916-786-6452
Practice Address - Street 1:755 SUNRISE AVE STE 115
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4583
Practice Address - Country:US
Practice Address - Phone:916-786-6055
Practice Address - Fax:916-786-6452
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24580111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24580Medicare ID - Type UnspecifiedMEDICARE NUMBER