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

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1194767921

Russell A. Grootegoed, DPM is a Foot & Ankle Surgery Podiatrist in San Pedro, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2006
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

601 W 9th St
San Pedro, CA 90731-3107
Phone: (310) 833-3583
Fax: (310) 833-1976
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence E2064 (CA)
Prosthetic/Orthotic Supplier Taxonomy 335E00000X · Licence E2064 (CA)

Record details

NPI number1194767921
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedJune 13, 2006
Last updated in NPPESApril 11, 2008

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