Individual
RUSSELL SETSUDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1647 N LAVE AVE, APT 2, PASADENA, CA 91104
(626) 644-4288
Mailing address
1647 N LAVE AVE, APT 2, PASADENA, CA 91104
(626) 644-4288
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
39280
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1CD0KA7KD43
—
CA
Enumeration date
08/10/2022
Last updated
08/10/2022
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