| Kenneth Russ Md, Professional Corporation | |
|
490 S Farrell Dr Ste C106 Palm Springs CA 92262-7962 | |
| (760) 416-6773 | |
| Not Available |
| Full Name | Kenneth Russ Md, Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 490 S Farrell Dr Ste C106, Palm Springs, California |
| Authorized Official Name and Position | Kenneth Russ (PRESIDENT) |
| Authorized Official Contact | 9495882190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Russ Md, Professional Corporation 5 Holland Ste 101 Irvine CA 92618-2568 Ph: (949) 588-2190 | Kenneth Russ Md, Professional Corporation 490 S Farrell Dr Ste C106 Palm Springs CA 92262-7962 Ph: (760) 416-6773 |
| NPI Number | 1316428931 |
|---|---|
| Provider Enumeration Date | 08/22/2018 |
| Last Update Date | 08/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316428931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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