Russell Bruce Hubbard MD Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RUSSELL BRUCE HUBBARD MD INC

Practice address

1565 Hotel Cir S Ste 310
San Diego, CA 92108-3419

Phone

(619) 295-8005

Fax

(619) 297-1700

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russell Bruce Hubbard, M.D.NPI 1992879472

Title

Owner

Phone

(619) 295-8005

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell Bruce Hubbard, M.D.

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1992879472
  Medicare reassignment Care Compare group Authorized official
• Ashraf F Fanous, M.D.

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1083830350
  Medicare reassignment Care Compare group NPD
• Rizwan Sami Khan, P.A.

  • Physician Assistant
  • Spokane, WA
  • NPI 1104145481

  CA

  Medicare reassignment Care Compare group
• Karishma Patel, M.D.

  • Child & Adolescent Psychiatry Physician
  • San Diego, CA
  • NPI 1740644111
  Medicare reassignment NPD
• Ann Ryan Wycoff

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1821580143
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1053430744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "619-295-8005",
            "fax_number": "619-297-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 HOTEL CIR S STE 310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083419",
            "telephone_number": "619-295-8005",
            "fax_number": "619-297-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL BRUCE HUBBARD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-295-8005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCPACS (DEPT. LABOR WC)",
            "identifier": "125585700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE #",
            "identifier": "G25680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Rusonik
• Randal Christian Russ, DDS
• Valentina Russack, MD
• Jayna Russel
• Russell B Hays MD Inc
• Russell Chiropractic & Acupuncture, Inc
• Russell P Edwards, MD Apc
• Alexius Russell
• Bethany Zylstra Coleman Russell, OT
• Bonnie Russell, B.S.

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.