Sudha A Russell
Pediatrician Pediatric Emergency Physician
1835 N Broadway
Santa Maria
, California 93454-1404
Sudha A Russell
Pediatrician Pediatric Emergency Physician
1835 N Broadway
Santa Maria
, California 93454-1404
(661) 326-1347
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About
Features
Specialties
- Pediatric Emergency Physician
- Pediatrician
Languages spoken
- English
Location
First Address
- Sudha A Russell
- Po Box 1559
- Bakersfield, CA
- Zip : 93302-1559
- Fax : (661) 326-1347
- Phone : (661) 635-3050
Second Address
- Sudha A Russell
- 1835 N Broadway
- Santa Maria, CA
- Zip : 93454-1404
- Fax : (805) 345-3745
- Phone : (805) 345-3701
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207PP0204X | Pediatric Emergency Physician | G54900 | CA |
| Y | 208000000X | Pediatrician | G54900 | CA |
National Provider Identifier
| NPI | 1528037892 |
|---|---|
| Provider Name | Sudha A Russell |
| First Address | Bakersfield, CA 93302-1559 |
| Second Address | Santa Maria, CA 93454-1404 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/03/2006 |
| Last Update Date | 12/08/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 057297799 | (05) | FL |
| 10100 | BCBS PROVIDER # (01) | FL |
| A89980 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.