KENNETH CARL RUSS MD INC NPI 1760334312

NPI Information

  • NPI: 1760334312
  • Provider Name: KENNETH CARL RUSS MD INC
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • Address: 36917 COOK ST STE 103
    PALM DESERT, CA
    ZIP 92211
  • Phone: (760) 835-0425

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NPI Details

KENNETH CARL RUSS MD INC is an addiction medicine family medicine in Palm Desert, CA. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. KENNETH CARL RUSS MD INC NPI is 1760334312. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

36917 COOK ST STE 103
PALM DESERT, CA
ZIP 92211-072
Phone: (760) 835-0425

The provider's authorized official is Kenneth C Russ .
The authorized official title is Owner and has the following contact phone number (949) 588-2190.

The enumeration date for this NPI number is 2/13/2026 and was last updated on 2/13/2026.

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
1207QA0401XFamily MedicineAddiction MedicineYes

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: 11/21/2025

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