John Baptist Russo, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

A39364 Issued in CA

Practice address

593 W 6TH St
San Pedro, CA 90731-2521

Phone

(310) 547-0202

Fax

(310) 547-5096

NPI assigned

May 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013120286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312521",
            "telephone_number": "310-547-0202",
            "fax_number": "310-547-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312521",
            "telephone_number": "310-547-0202",
            "fax_number": "310-547-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JOHN",
        "middle_name": "BAPTIST",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A39364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guillermo Javier Rubiano Jr., DDS
• Anthony Francis Rubino, D.D.S.
• Oralia Rubio
• Russell a. Grootegoed DPM
• Jeffrey Raymond Russell II
• Karen Marie Russo
• Rustin Wilson Chiropractic Corporation
• Ryan Chang, DDS Inc
• Marc Pierson Ryan, L.AC.
• Nina Sabet-Peyman, M.D.

• Public Health & General Preventive Medicine Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Public Health & General Preventive Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.