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RUSSELL A. GROOTEGOED DPM
NPI 1194767921
Podiatrist - Foot & Ankle Surgery in San Pedro, CA

Active since June 13, 2006
601 W 9TH ST, SAN PEDRO, CA 90731(310) 833-3583(310) 833-1976 Get Directions Write a Review

NPPES record last updated: April 11, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Russell A. Grootegoed Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUSSELL A. GROOTEGOED DPM (NPI 1194767921) is an individual foot & ankle surgery provider in San Pedro, California, licensed in California (E2064) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1194767921
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameRUSSELL A. GROOTEGOEDCredential: DPM
Location Address601 W 9TH STSan Pedro, CA 90731-3107
Mailing Address601 W 9th StSan Pedro, CA 90731-3107 · (310) 833-3583 · Fax (310) 833-1976
Phone(310) 833-3583
Fax(310) 833-1976
Sole ProprietorYes
Enumeration DateJune 13, 2006
Last NPPES UpdateApril 11, 2008
✔ NPI 1194767921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in CA · E2064
Also ListedProsthetic/Orthotic SupplierTaxonomy 335E00000X · License E2064 (CA)
601 W 9TH ST, San Pedro, CA 90731
Open in Google Maps ↗

Other Identifiers 5

Other953239247CA · Blue Cross
Medicare UPINT11163CA
Medicare NSC3899650001CA
Medicare PINE2064CA
Medicaid000E2064000CA

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RUSSELL A. GROOTEGOED DPM
Prosthetic/Orthotic Supplier
601 W 9TH ST
SAN PEDRO, CA 90731
Los Angeles County (310) 833-3583

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Grootegoed's NPI number?

The NPI number for Russell Grootegoed is 1194767921. It was assigned to this individual provider in the NPPES registry on June 13, 2006.

Where is Russell Grootegoed located?

Russell Grootegoed practices at 601 W 9th St, San Pedro, CA 90731. The listed phone number is (310) 833-3583.

What is Russell Grootegoed's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for Russell Grootegoed was last updated on April 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.