Russell, Michael
Russell, Michael is an individual health care provider with primary practice located at 2220 Gladstone Dr Suite 3, Pittsburg CA 94565-5123. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Russell, Michael can be contacted via phone (925) 432-3318.Contact Information
Primary practice address
2220 Gladstone Dr Suite 3
Pittsburg CA 94565-5123
Phone: (925) 432-3318
Fax: (925) 432-0886
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G30873 | California |
Profile Details
| NPI number | 1578615316 |
|---|---|
| LBN Legal business name | Russell, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Jan 5th, 2012 - about 13 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 | 1578615316 | NPPES |
| California | MEDICAID | 00G308730 |
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