person
Edgar Russell, DO
Adult Medicine Physician in Riverside, California
NPI 1790707156

Edgar Russell is an Adult Medicine Physician based in San Dimas, CA and is specialized in Adult Medicine. Edgar Russell practices in Riverside, CA and has the professional credentials of DO. The NPI Number for Edgar Russell is 1790707156 and holds a License No. 20A6100 (California).

The current practice location address for Edgar Russell is 6276 River Crest Dr, Riverside, CA and can be reached out via phone at 951-413-0964 and via fax at 951-653-5161. You can also correspond with Edgar Russell through the mailing address at 1413 CALLE DE ORO, SAN DIMAS, CA - 91773-4015 (mailing address contact number: 909-592-4566).

Location: 6276 River Crest Dr, Riverside, CA, 91773-4015
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Provider Profile Details
NPI Number
1790707156
Provider Name
Edgar Russell
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
6276 River Crest Dr, Riverside, CA, 91773-4015
Phone Number
951-413-0964
Fax Number
951-653-5161
Provider Enumeration Date
07/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GR0086790 05 CA
institution
Provider Business Practice Location Address Details
Address
6276 River Crest Dr
City
State
Zip
92507-0754
Phone Number
951-413-0964
Fax Number
951-653-5161
person
Provider Business Mailing Address Details
Address
6276 River Crest Dr
City
State
Zip
92507-0754
Phone Number
951-413-0964
Fax Number
951-653-5161
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
License No.
20A6100 (California)
Definition
Definition to come.
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