Individual
MARCIA MCGORY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA STE 214, LOS ANGELES, CA 90095-0001
(310) 825-6078
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 268-4248
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A84671
CA
208C00000X
Colon & Rectal Surgery Physician
244029
MA
208C00000X
Colon & Rectal Surgery Physician
Primary
A84671
CA
Other
Enumeration date
01/08/2007
Last updated
07/21/2022
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