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

Mr. Peter Joseph Russo, PA

Individual provider Surgical Physician Assistant · NPI 1588729941

Mr. Peter Joseph Russo, PA is a Surgical Physician Assistant in Stockton, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2545 W Hammer Ln
Stockton, CA 95209-2839
Phone: (209) 957-7050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA14699 (CA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA14699 (CA)

Record details

NPI number1588729941
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 26, 2006
Last updated in NPPESApril 10, 2015

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