Individual
KEVIN RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 W CARSON ST, TORRANCE, CA 90502-2004
(310) 222-2401
Mailing address
3315 WATT AVE, SACRAMENTO, CA 95821-3600
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A164846
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2016
Last updated
07/25/2022
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