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NPI Code Detail

MEDICARE: MRS. GAIL A RUSSELL MD

MEDICARE: MRS. GAIL A RUSSELL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician18235WV
2207V00000XObstetrics & Gynecology PhysicianG89255CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578558896
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GAIL A RUSSELL MD
Provider Business Mailing Address
First Line : 10470 OLD PLACERVILLE RD
Second Line : SUITE 100
City : SACRAMENTO
State : CA
Zip : 95827-2539
Country : US
Telephone Number : 800-470-0071
Fax Number :
Provider Business Practice Location Address
First Line : 10470 OLD PLACERVILLE RD
Second Line : SUITE 100
City : SACRAMENTO
State : CA
Zip : 95827-2539
Country : US
Telephone Number : 800-470-0071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 05/11/2015

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Directions to “ MRS. GAIL A RUSSELL MD” Practice Location

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