Blackburn, Russell Leslie

Blackburn, Russell Leslie is an individual health care provider with primary practice located at 21297 Foothill Blvd Suite 201, Hayward CA 94541-1554. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blackburn, Russell Leslie can be contacted via phone (510) 538-4636.

Contact Information

Primary practice address
21297 Foothill Blvd Suite 201 Hayward CA 94541-1554
Phone: (510) 538-4636
Fax: (510) 538-1615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A31946 California

Profile Details

NPI number 1265448716
LBN Legal business name Blackburn, Russell Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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