Phyllis Ross, PHYSICIAN ASSITANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA12182 Issued in CA

Practice address

777 Flower St Ste a
Glendale, CA 91201-3000

Phone

(818) 637-2000

Fax

(818) 242-8761

NPI assigned

Oct 10, 2006

Last updated

Oct 1, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeside Medical Associates, a Medical Group, Inc.

  dba Lakeside Community Healthcare Medical Group

  • Hospitalist Physician
  • Glendale, CA
  • NPI 1932129434
  NPD (past)
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1568550317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W WEST COVINA PKWY",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902703",
            "telephone_number": "626-926-3702",
            "fax_number": "626-960-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013000",
            "telephone_number": "818-637-2000",
            "fax_number": "818-242-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "PHYLLIS",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSITANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosewood Home & Palliative Care, Inc
• Rosewood Hospice & Palliative Care, Inc
• Abigail Ross
• Angela Kelly Ross, SLP
• Kimberly C. Ross, MD, MBA
• Trevor Ross
• Rossmoyne Hills Senior Living Inc.
• Helen Rostamloo, MD
• Nairi Rostomian, DO
• Ani Rostomyan

• Medical Physician Assistant in Glendale, CA
• Providers in Glendale, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.