EDGAR RUSSELL

RIVERSIDE, CA
NPI1790707156
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207QA0505X Family Medicine, Adult Medicine
(Licence: CA  20A6100)
Enumeration Date2006-07-24
Last Update Date2007-07-09
Business Address
-- EDGAR RUSSELL D.O.
6276 RIVER CREST DR
RIVERSIDE, CA 92507-0754
Phone number: 951-413-0964
Mailing Address
-- EDGAR RUSSELL D.O.
1413 CALLE DE ORO
SAN DIMAS, CA 91773-4015
Phone number: 909-592-4566
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