Individual
RUSSELL JAMES MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
875 BLAKE WILBUR DRIVE, PALO ALTO, CA 94305
(650) 724-6480
(650) 724-7091
Mailing address
3941 SAN DIMAS ST, STE 102, BAKERSFIELD, CA 93301-5711
(661) 324-6593
(661) 324-3680
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 19738
CA
Other
Enumeration date
10/13/2009
Last updated
02/24/2016
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