Hines, Russell
Hines, Russell is an individual health care provider with primary practice located at 2230 Lynn Rd Suite 200, Thousand Oaks CA 91360-1901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Hines, Russell can be contacted via phone (805) 495-1066.Contact Information
Primary practice address
2230 Lynn Rd Suite 200
Thousand Oaks CA 91360-1901
Phone: (805) 495-1066
Fax: (805) 497-1428
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G77511 | California |
Profile Details
| NPI number | 1548213101 |
|---|---|
| LBN Legal business name | Hines, Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548213101 | NPPES |
| California | MEDICAID | 00G775110 |
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