Niles, Russell E.

Niles, Russell E. is an individual health care provider with primary practice located at 3000 Q St , Sacramento CA 95816-7058. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Niles, Russell E. can be contacted via phone (916) 733-5336.

Contact Information

Primary practice address
3000 Q St Sacramento CA 95816-7058
Phone: (916) 733-5336
Fax: (916) 733-5385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X G32453 California

Profile Details

NPI number 1023022696
LBN Legal business name Niles, Russell E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Feb 10th, 2012 - about 14 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 1023022696 NPPES
California Other 1211321 GREAT WEST
California Other 4054751 GREAT WEST
California Other MCMG170800 GREAT WEST
California Other 216368 GREAT WEST
California Other 4364920 GREAT WEST
California Other 90018849 GREAT WEST
California Other 000810354304 GREAT WEST
California Other 14028 GREAT WEST
California Other 012413 GREAT WEST
California Other 4812 GREAT WEST
California Other G62453 GREAT WEST
California MEDICAID 00G324530 GREAT WEST

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