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Contact Information

SUDHA A RUSSELL, MD
1835 N BROADWAY
SANTA MARIA, CA93454-1404
 Phone: 805-345-3701
 Fax: 805-345-3745
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SUDHA A RUSSELL · (Female)

NPI Number 1528037892
Status Active
Credentials MD
Entity Individual
Enumeration date 03/17/2006
Last updated 08/12/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • CA License # G54900
  • FL Medicaid 057297799
  • FL Other 10100 BCBS PROVIDER #
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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