Individual
DANA LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1200 N STATE ST, LOS ANGELES, CA 90089-1001
(323) 409-1000
Mailing address
4264 GRAND VIEW BLVD, LOS ANGELES, CA 90066-5820
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A19547
CA
Other
Enumeration date
03/22/2019
Last updated
01/23/2024
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