Individual
ANTHONY W. RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 N ASHWOOD AVE, VENTURA, CA 93003
(805) 658-5800
(805) 642-1928
Mailing address
5855 OLIVAS PARK DR, VENTURA, CA 93003-7672
(805) 667-2801
(805) 667-2865
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A85115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A851150
—
CA
Enumeration date
11/01/2006
Last updated
09/28/2018
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