Russell M Gilbertson MD a Professional Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G476910 Issued in CA

Legal business name

RUSSELL M GILBERTSON MD A PROFESSIONAL CORPORATION

Practice address

1246 W 155TH St
Gardena, CA 90247-4011

Phone

(562) 407-2080

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Russell Gilbertson, MDNPI 1326077033

Title

President

Phone

(562) 407-2080

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Russell Gilbertson, MD

  • Anesthesiology Physician
  • Lakewood, CA
  • NPI 1326077033
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1942377189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 W 155TH ST",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474011",
            "telephone_number": "562-407-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL M GILBERTSON MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "GILBERTSON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-407-2080",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G476910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G476910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariam Yobana Ruiz
• Yajaira Ruiz
• Yuvicela Alicia Ruiz
• Ronald Alan Rulison Jr., MSW
• Tony Rushing
• Jamie D. Russell
• Derian Ruth-Williams
• Elissa R. Rynearson, PT, DPT
• S. Yousefi Dental Corporation
• Kristin Darlene Saad, FNP

• Anesthesiology Physician in Gardena, CA
• Providers in Gardena, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.