| Scott Russell Do Inc | |
|
41120 Washington St Ste 210 Bermuda Dunes CA 92203-9596 | |
| (760) 391-8436 | |
| Not Available |
| Full Name | Scott Russell Do Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 41120 Washington St Ste 210, Bermuda Dunes, California |
| Authorized Official Name and Position | Scott Russell (PRESIDENT) |
| Authorized Official Contact | 7603918436 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Russell Do Inc 45815 Camino Vis Ste 210 La Quinta CA 92253-7231 Ph: (760) 391-8436 | Scott Russell Do Inc 41120 Washington St Ste 210 Bermuda Dunes CA 92203-9596 Ph: (760) 391-8436 |
| NPI Number | 1144919911 |
|---|---|
| Provider Enumeration Date | 05/05/2023 |
| Last Update Date | 05/22/2023 |
| Medicare PECOS PAC ID | 2860852274 |
|---|---|
| Medicare Enrollment ID | O20230717003679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144919911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Scott A Russell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073581237 PECOS PAC ID: 7719085281 Enrollment ID: I20120501000547 |
| Provider Name | Pittawat Emerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437492097 PECOS PAC ID: 2961745260 Enrollment ID: I20190529001757 |
Medical Wellness Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 41749 Brownstown Dr, Bermuda Dunes, CA 92203 Phone: 760-636-9893 | |
Clinica Del Sol Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41120 Washington St, Suite 103, Bermuda Dunes, CA 92203 Phone: 760-772-3348 Fax: 760-772-8414 | |
Mattie Evans Alderman Foundation, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41800 Washington St, Suite #110, Bermuda Dunes, CA 92203 Phone: 760-345-2696 Fax: 760-345-4961 | |
Herr-kostic Medical Group Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 41-120 Washington St, Suite 101, Bermuda Dunes, CA 92203 Phone: 760-772-2823 Fax: 760-772-2819 | |
Mattie Evans Alderman Foundation For Preventive Medicine, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41800 Washington St Ste 110, Bermuda Dunes, CA 92203 Phone: 760-345-2696 Fax: 760-345-4961 |