SearchCalifornia213ES0103X

Russell Grootegoed, DPM

NPI 1194767921 · on the registry since 2006 · sole proprietor

Practice

Address
601 W 9th St
San Pedro, CA 90731
Phone
(310) 833-3583
Fax
(310) 833-1976
Organisation at this address
Russell A. Grootegoed Dpm
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
213ES0103X
213ES0103X
Also registered as
335E00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2008-04-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California