Organization
SCOTT RUSSELL DO INC
Active
Other names
Scott Russell DO, MHA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT RUSSELL DO (PRESIDENT)
(760) 391-8436
Entity
Organization
Contact information
Practice address
41120 WASHINGTON ST STE 210, BERMUDA DUNES, CA 92203-9596
(760) 391-8436
Mailing address
45815 CAMINO VIS STE 210, LA QUINTA, CA 92253-7231
(760) 391-8436
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/05/2023
Last updated
05/22/2023
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