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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548213101 NPPES
California MEDICAID 00G775110

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