MR. RUSSELL DAVID FIKE (NPI# 1891252680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891252680 |
| Entity Type | Individual |
| Full Name | MR. RUSSELL DAVID FIKE |
| Credential | PA-C |
| Practice Address |
4477 W 118th St Ste 409 Hawthorne CA 90250-2259 |
| Mailing Address |
2502 E Willow St Unit 109 Signal Hill CA 90755-2252 |
| Practice Telephone | 3102190647 |
| Mailing Telephone | 5623559728 |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 56568 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
56568 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4477 W 118TH ST STE 409 |
| City | HAWTHORNE |
| State | CA |
| Zip Code | 90250-2259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467941401 | Jaewon Lee | Nurse Practitioner | 4477 W 118th St Ste 409, Hawthorne, CA 90250-2259 | 2018-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508479627 | Alexis Lemmon | Dental Hygienist | 13450 Hawthrone Blvd, Hawthorne, CA 90250 | 2020-08-28 |
| 1336620459 | Lan Ngoc Ton | Dentist | 13450 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2018-08-27 |
| 1356829261 | Karneth Health Inc | Internal Medicine | 4512 W. Imperial Hwy, Ste B, Hawthorne, CA 90250 | 2018-08-02 |
| 1225524663 | Viridian Healthcare LLC | In Home Supportive Care | 13658 Hawthorne Blvd Ste 201, Hawthorne, CA 90250 | 2018-07-09 |
| 1235636044 | Sonia Medical Center Inc | Clinic/Center | 4512 W Imperial Hwy, Hawthorne, CA 90250 | 2018-04-09 |
| 1518484807 | Jessica Anne-marie Auzenne-harris | Nurse Practitioner | 12618 Hawthorne Blvd, Hawthorne, CA 90250 | 2017-08-28 |
| 1669993358 | Ololade Olamide Obafemi | Nurse Practitioner | 12954 Hawthorne Boulevard, Suite 104, Hawthorne Morningside Medical Clinic, Hawthorne, CA 90250 | 2017-07-03 |
| 1588194534 | Marissam Medical Inc. | Durable Medical Equipment & Medical Supplies | 13508 Inglewood Ave, Hawthorne, CA 90250 | 2017-06-13 |
| 1043751886 | Ogbonna Iwuamadi Olelewe | Nurse Practitioner | 11712 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2017-03-13 |
| 1952758898 | La Shada Kai Martin | Contractor | 13010 Kornblum Ave, Unit D, Hawthorne, CA 90250 | 2016-05-20 |
| Find all providers in zip 90250 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102671 | Brie Elizabeth Noelte | Physician Assistant | 19 Bradhurst Ave Ste 2750, Hawthorne, NY 10532-2139 | 2019-09-10 |
| 1972887842 | Kristina Leigh Kupryk | Physician Assistant | 245 Diamond Bridge Avenue, Hawthorne, NJ 07506 | 2011-10-10 |
| 1720271406 | Sonja Farmer | Physician Assistant | 4477 W 118th St Ste 200, Hawthorne, CA 90250-2257 | 2007-08-24 |
| 1255431722 | Hector Eduardo Collantes Jr. | Physician Assistant | 13425 Inglewood Avenue, Hawthorne, CA 90250 | 2006-09-25 |
| 1982229100 | Joseph Morgan | Physician Assistant | 21815 Se 71st Ave, Hawthorne, FL 32640-3974 | 2020-06-12 |
| 1235695669 | Ashley Jane Prasad | Physician Assistant | 19 Bradhurst Ave Ste 2850s, Hawthorne, NY 10532-2140 | 2019-02-11 |
| 1508246067 | Caitlin Morgan | Physician Assistant | 4455 W 117th St Ste 300, Hawthorne, CA 90250-2240 | 2015-05-31 |
| 1881838068 | Anthony Mangieri | Physician Assistant | 297 Lafayette Ave, Hawthorne, NJ 07506-1919 | 2009-05-01 |
| 1568651743 | Reshma Patel | Physician Assistant | 2301 W El Segundo Blvd, Hawthorne, CA 90250-3315 | 2007-10-23 |
| 1538363536 | Leah Bienstock | Physician Assistant | 245 Diamond Bridge Ave, Hawthorne, NJ 07506-1984 | 2007-06-13 |
| Find all providers in HAWTHORNE | ||||
Please comment or provide details below to improve the information on MR. RUSSELL DAVID FIKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.