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MICHAEL DAVID RUSSELL MD MBA MPH NPI 1710484472


NPI Information

NPI: 1710484472
Provider Name: MICHAEL DAVID RUSSELL, MD, MBA, MPH
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 45D1015478

Address:
1131 WILSHIRE BLVD STE 100
SANTA MONICA, CA
ZIP 90401
Phone: (310) 319-3475
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Michael David Russell, MD, MBA, MPH is an orthopaedic surgery in Santa Monica, CA with 6 years of experience. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. Michael David Russell, MD, MBA, MPH NPI is 1710484472. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduation Year:2018

The provider's business location address is:

1131 WILSHIRE BLVD STE 100
SANTA MONICA, CA
ZIP 90401-072
Phone: (310) 319-3475

The NPI 1710484472 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 CLIA number assigned to this NPI record is 45D1015478 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/10/2018 and was last updated on 8/7/2023.


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
1207X00000XOrthopaedic SurgeryA185250CALIFORNIAYes

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: 4/28/2024

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