Individual
MR. BRUCE GARY RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC., M.S.T.O.M.
Contact information
Practice address
23331 EL TORO RD, SUITE 106, LAKE FOREST, CA 92630-4891
(949) 859-9696
(949) 859-1951
Mailing address
24112 BIRDROCK DR, LAKE FOREST, CA 92630-4403
(949) 707-5330
(949) 859-1951
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 8877
CA
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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