Rodriguez, Russell Gerald

Rodriguez, Russell Gerald is an individual health care provider with primary practice located at 3901 Lone Tree Way , Antioch CA 94509-6200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Rodriguez, Russell Gerald can be contacted via phone (925) 779-7273.

Contact Information

Primary practice address
3901 Lone Tree Way Antioch CA 94509-6200
Phone: (925) 779-7273
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X A84370 California
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X A84370 Hawaii

Profile Details

NPI number 1245259647
LBN Legal business name Rodriguez, Russell Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Oct 10th, 2019 - about 6 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 1245259647 NPPES
California MEDICAID 00A843700

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