Individual
MR. ROSS G MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1428 PHILLIPS LN STE 203, SAN LUIS OBISPO, CA 93401-2551
(805) 543-4407
(805) 543-4587
Mailing address
1304 ELLA ST STE A, SAN LUIS OBISPO, CA 93401-4165
(805) 549-9555
(805) 549-0444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22917
OK
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
C53777
CA
207RP1001X
Pulmonary Disease Physician
Primary
C53777
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9292457
AETNA
CA
01
—
C53777
MEDICAL LICENSE
CA
Enumeration date
02/08/2007
Last updated
11/03/2023
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