Gray, Russell

Gray, Russell is an individual health care provider with primary practice located at 1500 E Duarte Rd , Duarte CA 91010. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gray, Russell can be contacted via phone (626) 359-8111.

Contact Information

Primary practice address
1500 E Duarte Rd Duarte CA 91010
Phone: (626) 359-8111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X G55505 California

Profile Details

NPI number 1265499065
LBN Legal business name Gray, Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Dec 15th, 2020 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1265499065 NPPES
California MEDICAID 00G555050

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