Bryan Clint Russell, is a
Physical Medicine & Rehabilitation physician based in Coronado, California. Bryan Clint Russell is licensed to practice in California (license number PT295117) and his current practice location is 160 C Ave, Coronado, California. He can be reached at his office (for appointments etc.) via phone at
(619) 319-5992.
NPI number for Bryan Clint Russell is 1407320260 and his current mailing address is 6621 Archwood Ave, San Diego, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1407320260.
Physician's Profile
| Full Name | Bryan Clint Russell |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 160 C Ave, Coronado, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1407320260
- Provider Enumeration Date: 01/15/2019
- Last Update Date: 01/15/2019
Medical Identifiers
Medical identifiers for Bryan Clint Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407320260 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | PT295117 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bryan Clint Russell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Bryan Clint Russell,
6621 Archwood Ave,
San Diego, CA 92120-2401
Ph: (619) 319-5992 | Bryan Clint Russell,
160 C Ave,
Coronado, CA 92118-1420
Ph: (619) 319-5992 |
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