Individual
KIM RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
18785 BROOKHURST ST STE 201, FOUNTAIN VALLEY, CA 92708-7300
(714) 916-0881
Mailing address
6591 WESTPARK PL APT C, WESTMINSTER, CA 92683-3071
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
74335
CA
Other
Enumeration date
01/18/2018
Last updated
04/21/2020
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