RUSSELL GROOTEGOED, DPM

Podiatrist - Foot & Ankle Surgery

Active Individual
NPI: 1194767921

Practice Address

601 W 9TH ST
San Pedro, CA 90731

Phone: (310) 833-3583

Specialties

Specialty Code Primary License
Podiatrist - Foot & Ankle Surgery 213ES0103X Yes E2064 (CA)
Prosthetic/Orthotic Supplier 335E00000X No E2064 (CA)

Frequently Asked Questions

NPI 1194767921 is the National Provider Identifier for RUSSELL GROOTEGOED, DPM, a Podiatrist - Foot & Ankle Surgery provider located in San Pedro, CA. This NPI was enumerated on June 13, 2006.
RUSSELL GROOTEGOED, DPM practices at 601 W 9TH ST, San Pedro, CA 90731.

Quick Facts

NPI
1194767921
Type
Individual
Enumerated
Jun 13, 2006
Last Updated
Apr 11, 2008

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