SearchCalifornia364S00000X

Ryan Russo

NPI 1295336956 · on the registry since 2020 · sole proprietor

Practice

Address
2376 Soto St
San Diego, CA 92107
Phone
(414) 803-6018

Registry record

Primary taxonomy
364S00000X
364S00000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-11-07

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