Individual
RUSSELL PIAZZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
873 RICARDO COURT, SAN LUIS OBISPO, CA 93401
(805) 784-0515
Mailing address
873 RICARDO CT, SAN LUIS OBISPO, CA 93401-7174
(805) 784-0515
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
26644
CA
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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