Individual
MICHAEL DAVID RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA, MPH
Contact information
Practice address
1131 WILSHIRE BLVD STE 100, SANTA MONICA, CA 90401-2072
(310) 319-3475
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A185250
CA
Other
Enumeration date
04/10/2018
Last updated
08/07/2023
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