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

Michael Anthony Russo, MD

Individual provider Surgery Physician · NPI 1700084381

Michael Anthony Russo, MD is a General Surgery in Fountain Valley, California. Graduated from Toledo Medical College in 2007, 19 years ago. Practices with Leport Surgical Medical Corporation, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Texas.

Years since qualifying
19
Trained at
Toledo Medical College
Licensed in
CA, TX
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1811 Brookfurst St #5600
Fountain Valley, CA 92708-6728
Phone: (714) 861-4666
Fax: (714) 861-4682
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence A125016 (CA)
Surgery Physician Taxonomy 208600000X · Licence Q1013 (TX)

Record details

NPI number1700084381
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 5, 2007
Last updated in NPPESMarch 7, 2023
Mailing address1811 Brookfurst St #5600, Fountain Valley, CA 92708-6728

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolTOLEDO MEDICAL COLLEGE
Graduated 2007 (19 years in practice)
Group practice Leport Surgical Medical Corporation — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fountain Valley