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
Phone: (760) 776-1113
Fax: (760) 776-1113
Website:
Health care specialties
| Specialty | Code | License # | 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 last year |
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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