Individual
MR. RUSSELL COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.T.
Contact information
Practice address
385 S. LEMON AVE. STE 249, WALNUT, CA 91789
(714) 403-8515
(714) 669-4088
Mailing address
385 S. LEMON AVE. STE 249, WALNUT, CA 91789
(714) 403-8515
(714) 669-4088
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
RHM-6244
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R059983
MEDICARE
CA
Enumeration date
01/21/2008
Last updated
03/25/2010
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