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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RUSSELL A. GROOTEGOED, DPM

Active Sole Proprietor

RUSSELL A. GROOTEGOED, DPM is a Foot & Ankle Surgery Podiatrist healthcare provider located in SAN PEDRO, California. NPI 1194767921 is currently active in the NPPES registry. Verify at CMS.

Foot & Ankle Surgery Podiatrist · SAN PEDRO, CA

Registration Details

NPI Number
1194767921
Provider Type
Individual
Gender
Male
NPI Issued
Jun 13, 2006 (20.207260624023 yrs)
Last Updated
Apr 11, 2008
Licenses
E2064 (CA)
E2064 (CA)
Sole Proprietor
Yes

Practice Information

Address
601 W 9TH ST
SAN PEDRO, CA, 907313107
Browse CA providers · Browse ZIP 90731
Phone
3108333583
Fax
3108331976
Primary Specialty
Foot & Ankle Surgery Podiatrist
213ES0103X
Additional Specialty
Prosthetic/Orthotic Supplier

Other Foot & Ankle Surgery Podiatrist Providers in SAN PEDRO, CA

Name Credential NPI
TAD FENNAR DPM 1134151194
ERIC M FEIT DPM, INC 1366534216
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.