RUSSELL ROBERT WYCOFF MD NPI 1740384304

NPI Information

NPI: 1740384304
Provider Name: RUSSELL ROBERT WYCOFF, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Address:
751 CORDOVA STREET
SUITE #1
PASADENA, CA
ZIP 91101
Phone: (626) 577-2424
Get Directions

Russell Robert Wycoff, MD is a diagnostic radiology radiology in Pasadena, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Russell Robert Wycoff, MD NPI is 1740384304. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

751 CORDOVA STREET
SUITE #1
PASADENA, CA
ZIP 91101-617
Phone: (626) 577-2424
Fax: (626) 577-2995

The enumeration date for this NPI number is 9/12/2006 and was last updated on 7/8/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	G16750	CALIFORNIA	Yes
2	2085R0204X	Radiology	Vascular & Interventional Radiology	G16750	CALIFORNIA	X

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A39894	MEDICARE UPIN

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

NPI Synchronization or Removal

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