# RUSSELL P EDWARDS, MD APC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093854705
- **Authorized official:** DR. RUSSELL P EDWARDS M.D. (OWNER)
- **Authorized official phone:** (619) 291-6191

## Contact information

- **Practice address:** 3969 4TH AVE, SUITE 301, SAN DIEGO, CA 92103-3165
- **Practice address phone:** (619) 291-6191
- **Practice address fax:** (619) 291-0049
- **Mailing address:** 3969 4TH AVE, SUITE 301, SAN DIEGO, CA 92103-3165
- **Mailing address phone:** (619) 291-6191
- **Mailing address fax:** (619) 291-0049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | G57008 | CA | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 02/06/2015