R. Denis Russell, D.P.M., Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

E1393 Issued in CA

Legal business name

R. DENIS RUSSELL, D.P.M., INC.

Practice address

11100 Warner Ave
Suite 306
Fountain Valley, CA 92708-7506

Phone

(714) 979-0313

Fax

(714) 979-0340

NPI assigned

Feb 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. R Denis Russell, D.P.M.

Title

President

Phone

(714) 979-0313

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1720256407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 306",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-979-0313",
            "fax_number": "714-979-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 306",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-979-0313",
            "fax_number": "714-979-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. DENIS RUSSELL, D.P.M., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "R",
        "authorized_official_middle_name": "DENIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-979-0313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "E1393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Customized Equipment (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.