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1164465753
PAUL ROBERT RUSSO
SAN DIEGO, CA
NPI
1164465753
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA NP10524)
Enumeration Date
2006-06-13
Last Update Date
2007-07-09
Business Address
MR. PAUL ROBERT RUSSO FNP
34800 BOB WILSON DR
SAN DIEGO, CA 92134-1098
Phone number: 619-532-8109
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Mailing Address
MR. PAUL ROBERT RUSSO FNP
PO BOX 130192
CARLSBAD, CA 92013-0192
Phone number: 760-918-0980
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