Individual
RUSSELL VENANZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26542 EL MAR DR, MISSION VIEJO, CA 92691-6104
(949) 589-0145
Mailing address
26542 EL MAR DR, MISSION VIEJO, CA 92691-6104
(949) 589-0145
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
306002428
CA
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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