| Samuel Ross MD Inc | |
|
6360 Wilshire Blvd #102 Los Angeles CA 90048-5603 | |
| (323) 413-7677 | |
| Not Available |
| Full Name | Samuel Ross MD Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6360 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Samuel Ross (PRINCIPAL) |
| Authorized Official Contact | 3234137677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Ross MD Inc 6360 Wilshire Blvd #102 Los Angeles CA 90048-5603 | Samuel Ross MD Inc 6360 Wilshire Blvd #102 Los Angeles CA 90048-5603 Ph: (323) 413-7677 |
| NPI Number | 1366804825 |
|---|---|
| Provider Enumeration Date | 03/24/2016 |
| Last Update Date | 03/24/2016 |
| Medicare PECOS PAC ID | 9436457611 |
|---|---|
| Medicare Enrollment ID | O20160421001304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366804825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A133185 (California) | Primary |
| Provider Name | Samuel H Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689917486 PECOS PAC ID: 4284957507 Enrollment ID: I20141217002153 |
| Provider Name | Carmen Marti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093150633 PECOS PAC ID: 3375860414 Enrollment ID: I20150328000342 |
| Provider Name | Daniel Margolies |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427549278 PECOS PAC ID: 3274871231 Enrollment ID: I20190218000390 |
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