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Individual

RUSSELL DE JONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 576-1700
Mailing address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A207835
CA
208D00000X
General Practice Physician
33801
NE
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/04/2020
Last updated
06/17/2026
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