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General NPI Number Information
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NPI Number | 1972710309
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Entity Type | Organization
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Legal Business Name | RUSSELL J. ANDREWS MD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 244 MISTLETOE RD
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City | LOS GATOS
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State | CA
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Zip | 95032-1610
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Country | US
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Telephone | 408-829-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 244 MISTLETOE RD
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City | LOS GATOS
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State | CA
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Zip | 95032-1610
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Country | US
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Telephone | 408-829-1700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. RUSSELL JOSEPH ANDREWS
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Credential | MD
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Telephone | 408-829-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | G46747
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License Number State | CA
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