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Organization
RUSSELL R SLAUGH OD AN OPTOMETRIC CORPORATION
Active
Organization
RUSSELL R SLAUGH OD AN OPTOMETRIC CORPORATION
Active
Other names
Russell Slaugh
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL R SLAUGH O.D. (OPTOMETRIST)
(760) 228-2020
Entity
Organization
Contact information
Practice address
56970 YUCCA TRL, STE 101, YUCCA VALLEY, CA 92284-7910
(760) 228-2020
(760) 369-2020
Mailing address
56970 YUCCA TRL, STE 101, YUCCA VALLEY, CA 92284-7910
(760) 228-2020
(760) 369-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134103484
DENNIS G. LOWMAN O.D.
CA
01
—
1245517804
GROUP NPI
CA
01
—
1659684751
RUSSELL R SLAUGH O.D.
CA
01
—
1770922395
NPI
—
01
—
SD0142400
BLUE SHIELD
CA
01
—
ZZZ696612
BLUE SHIELD
CA
Enumeration date
11/10/2011
Last updated
06/20/2018
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