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Individual

DR. MELVIN F. RUSSI JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12200 COLINA DR, LOS ALTOS HILLS, CA 94024-5299
(650) 941-8212
Mailing address
12200 COLINA DR, LOS ALTOS HILLS, CA 94024-5299
(650) 941-8212

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
GFE11171
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GFE11171
MEDICAL BOARD OF CALIFORNIA CERTIFICATE
CA
Enumeration date
06/28/2010
Last updated
06/28/2010
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