Individual
DAVID RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19582 BEACH BLVD STE 250, HUNTINGTON BEACH, CA 92648-5977
(714) 477-8020
Mailing address
19582 BEACH BLVD STE 250, HUNTINGTON BEACH, CA 92648-5977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A181730
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2019
Last updated
01/22/2024
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