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MICHAEL ANTHONY RUSSO MD NPI 1700084381


NPI Information

NPI: 1700084381
Provider Name: MICHAEL ANTHONY RUSSO, MD
Classification: Surgery - 208600000X
Entity Type: Individual
Organization: LEPORT SURGICAL MEDICAL CORPORATION

PECOS Registration: Yes

Address:
1811 BROOKFURST ST #5600
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (714) 861-4666
Get Directions

Michael Anthony Russo, MD is a surgery in Fountain Valley, CA with 17 years of experience. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Michael Anthony Russo, MD NPI is 1700084381. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TOLEDO MEDICAL COLLEGE
Graduation Year:2007

The provider's business location address is:

1811 BROOKFURST ST #5600
FOUNTAIN VALLEY, CA
ZIP 92708-728
Phone: (714) 861-4666
Fax: (714) 861-4682

The NPI 1700084381 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/5/2007 and was last updated on 11/8/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryQ1013TEXASNo
2208600000XSurgeryA125016CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1LL1802OTHERNEVADANV MEDICAL LICENSE
2ASO2532199374OTHERNEVADANV BOARD OF PHARM
3ASO2532199374OTHERDEA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.