Organization
R. DENIS RUSSELL, D.P.M., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R DENIS RUSSELL D.P.M. (PRESIDENT)
(714) 979-0313
Entity
Organization
Contact information
Practice address
11100 WARNER AVE, SUITE 306, FOUNTAIN VALLEY, CA 92708-7506
(714) 979-0313
(714) 979-0340
Mailing address
11100 WARNER AVE, SUITE 306, FOUNTAIN VALLEY, CA 92708-7506
(714) 979-0313
(714) 979-0340
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
E1393
CA
Other
Enumeration date
02/14/2008
Last updated
02/14/2008
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