SearchCalifornia171100000X

Ross Lake, ROSS LAKE

NPI 1639247034 · on the registry since 2006 · sole proprietor

Practice

Address
311 Luce Ave
Ukiah, CA 95482
Phone
(707) 462-4448
Fax
(707) 595-5565
Organisation at this address
The Orthopedic Wellness Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address
3

Registry record

Primary taxonomy
171100000X
171100000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-06-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California