Russell, Richard Lee

Russell, Richard Lee is an individual health care provider with primary practice located at 3400 Delta Fair Blvd , Antioch CA 94509-4004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Russell, Richard Lee can be contacted via phone (925) 779-5000.

Contact Information

Primary practice address
3400 Delta Fair Blvd Antioch CA 94509-4004
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A18135 California

Profile Details

NPI number 1043399181
LBN Legal business name Russell, Richard Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Jul 8th, 2007 - about 19 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 1043399181 NPPES
California MEDICAID 00A181350

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