Most Relevant Information
Provider Data
| NPI Number: | 1003471939 |
| Provider Name: | HANA MARIE RUSSO MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/06/2019 |
| Last Updated: | 07/03/2023 |
Provider Practice Location
200 W ARBOR DR
SAN DIEGO
CA
921039000
Practice Location Phone/Fax
| Phone: | 8009268273 |
| Fax: | 8885398781 |
Provider Mailing Location
PO BOX 232410
SAN DIEGO
CA
921932410
Provider Mailing Phone/Fax
| Phone: | 8009268273 |
| Fax: |