Individual
MR. RUSS IPPOLITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDO
Contact information
Practice address
310 E ORANGETHORPE AVE, SUITE C, PLACENTIA, CA 92870-6507
(714) 572-8301
Mailing address
310 E ORANGETHORPE AVE, SUITE C, PLACENTIA, CA 92870-6507
(714) 572-8301
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D6954
CA
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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