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

Mitchell Russo, DPT

Individual provider Physical Therapist · NPI 1285267617

Mitchell Russo, DPT is a Physical Therapist in San Diego, California. Licensed in California. Registered with an NPI since 2020.

Licensed in
CA
In the registry since
2020
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

15004 Innovation Dr
San Diego, CA 92128-3491
Phone: (858) 605-7189
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 297093 (CA)

Record details

NPI number1285267617
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedFebruary 13, 2020
Last updated in NPPESFebruary 13, 2020
Certification dateFebruary 13, 2020

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