Russakow, Mitchell Bernard

Russakow, Mitchell Bernard is an sole proprietor health care provider with primary practice located at 72549 Highway 111 Target 0940, Palm Desert CA 92260-3306. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Russakow, Mitchell Bernard can be contacted via phone (760) 776-1113.

Contact Information

Primary practice address
72549 Highway 111 Target 0940 Palm Desert CA 92260-3306
Fax: (760) 776-1113
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 44922 California

Profile Details

NPI number 1497040042
LBN Legal business name Russakow, Mitchell Bernard
Credentials RPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2011
Last updated Jun 10th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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