Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bryan Clint Russell

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1407320260

Bryan Clint Russell is a Physical Therapist in Private Practice in Coronado, California. Qualified in 2018, 8 years ago. Practices with One Life Physical Therapy Inc, a 4-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2019

Practice location Address checks out

160 C Ave
Coronado, CA 92118-1420
Phone: (619) 319-5992
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence PT295117 (CA)

Record details

NPI number1407320260
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 15, 2019
Last updated in NPPESJanuary 15, 2019
Mailing address6621 Archwood Ave, San Diego, CA 92120-2401

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice One Life Physical Therapy Inc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Coronado