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1265448716
RUSSELL LESLIE BLACKBURN
HAYWARD, CA
NPI
1265448716
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA A31946)
Enumeration Date
2006-08-01
Last Update Date
2007-07-08
Business Address
RUSSELL LESLIE BLACKBURN MD
21297 FOOTHILL BLVD SUITE 201
HAYWARD, CA 94541-1554
Phone number: 510-538-4636
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Mailing Address
RUSSELL LESLIE BLACKBURN MD
21297 FOOTHILL BLVD SUITE 201
HAYWARD, CA 94541-1554
Phone number: 510-538-4636
Copy
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