Organization
KENNETH CARL RUSS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH C RUSS MD (OWNER)
(949) 588-2190
Entity
Organization
Contact information
Practice address
36917 COOK ST STE 103, PALM DESERT, CA 92211-6072
(760) 835-0425
Mailing address
5 HOLLAND STE 101, IRVINE, CA 92618-2568
(949) 588-2190
(949) 588-2199
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
02/13/2026
Last updated
02/13/2026
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