Russell Cook, R.T.
Individual provider Active NPI Radiologic Technologist · Walnut, CA
NPI 1508042516 · NPPES record last updated Mar 25, 2010
Key facts
- NPI
- 1508042516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiologic Technologist 247100000X
- License
- RHM-6244 (CA)
- Practice address
- 385 S. Lemon Ave. Ste 249
Walnut, CA 91789 - Phone
- (714) 403-8515
- Fax
- (714) 669-4088
- NPI assigned
- Jan 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RHM-6244 | CA | MD | Radiologic Technologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | RHM-6244 | CA | Yes |
Addresses
Primary practice location
385 S. Lemon Ave. Ste 249
Walnut, CA 91789
Mailing address
385 S. Lemon Ave. Ste 249
Walnut, CA 91789
Phone (714) 403-8515
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R059983 | Other | CA | MEDICARE |
Other providers in Walnut, CA
- Tsong Jun Chuang
- Joshua Chung
- Tony Chung
- Gabriel Cokro
- Bonita Louise Conway
- Ramon Coronado
- Vanessa Cortez
- Cynthia Cruz-Porto
- Nicole Renae Cuahutle
- Kyle Dalan
All providers in Walnut, CA · Radiologic Technologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.