Individual
MISS PHYLLIS ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSITANT
Contact information
Practice address
777 FLOWER ST STE A, GLENDALE, CA 91201-3000
(818) 637-2000
(818) 242-8761
Mailing address
1500 W WEST COVINA PKWY, WEST COVINA, CA 91790-2703
(626) 926-3702
(626) 960-3726
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12182
CA
Other
Enumeration date
10/10/2006
Last updated
10/01/2007
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