Individual
RUSSELL E. CONSIGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3160 FOLSOM BLVD, SACRAMENTO, CA 95816-5219
(916) 733-5336
(916) 733-5385
Mailing address
2914 58TH ST, SACRAMENTO, CA 95817-1741
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
PA10894
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10899748
GREAT WEST
CA
01
—
461130
INTERPLAN
CA
01
—
4663625
AETNA
CA
01
—
6753334
CIGNA
CA
01
—
90078280
PACIFICARE
CA
01
—
PA10894
BLUE CROSS
CA
05
—
PA10894
—
CA
Enumeration date
07/31/2006
Last updated
07/08/2007
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