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1700084381
MICHAEL ANTHONY RUSSO
FOUNTAIN VALLEY, CA
NPI
1700084381
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: CA A125016)
Additional Taxonomies
208600000X Surgery
(Licence: TX Q1013)
Enumeration Date
2007-07-05
Last Update Date
2023-03-07
Business Address
MICHAEL ANTHONY RUSSO MD
1811 BROOKFURST ST #5600
FOUNTAIN VALLEY, CA 92708-6728
Phone number: 714-861-4666
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Mailing Address
MICHAEL ANTHONY RUSSO MD
1811 BROOKFURST ST #5600
FOUNTAIN VALLEY, CA 92708-6728
Phone number: 714-861-4666
Copy
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