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Organization
FMR INTERVENTIONAL QUALITY PAIN MANAGEMENT, A PROFESSIONAL CORP
Active
Organization
FMR INTERVENTIONAL QUALITY PAIN MANAGEMENT, A PROFESSIONAL CORP
Active
Other names
FMR Interventional Quality Pain Management, FMR Interventional QPM
Organization subpart
No
Provider details
NPI number
Authorized official
F. MARINA RUSSMAN MD (MEDICAL DIRECTOR/OWNER)
(310) 294-9027
Entity
Organization
Contact information
Practice address
20620 LEAPWOOD AVE, SUITE H, CARSON, CA 90746
(310) 294-9027
(562) 453-3059
Mailing address
12415 NORWALK BLVD, UNIT 59600, NORWALK, CA 90652
(310) 294-9027
(562) 453-3059
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/06/2018
Last updated
07/28/2023
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