EDGAR RUSSELL (NPI# 1790707156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790707156 |
| Entity Type | Individual |
| Full Name | EDGAR RUSSELL |
| Credential | D.O. |
| Practice Address |
6276 River Crest Dr Riverside CA 92507-0754 |
| Mailing Address |
1413 Calle De Oro San Dimas CA 91773-4015 |
| Practice Telephone | 9514130964 |
| Practice Fax Number | 9516535161 |
| Mailing Telephone | 9095924566 |
| Mailing Fax Number | 9095766904 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
20A6100 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0086790 | 05 |
| Street Address |
6276 RIVER CREST DR |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92507-0754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023079183 | Haider Spine Center Medical Group | Physician Assistant | 6276 River Crest Dr, Riverside, CA 92507-0754 | 2006-03-29 |
| 1851755128 | Anthony Cramer | Physician Assistant | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2016-04-12 |
| 1255796389 | University Surgery Center, Inc | Clinic/Center | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2015-12-16 |
| 1376933283 | Haider Spine Center | Clinic/Center | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2015-01-30 |
| 1558664565 | Open Mri At Eagle Eye Riverside, LLC | Clinic/Center | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2010-12-13 |
| 1871810762 | Rivercrest Physical Therapy, Inc. | Clinic/Center | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2010-04-30 |
| 1407173396 | Rivercrest Mri, Inc. | Clinic/Center | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2010-04-30 |
| 1609193705 | Mission Medical Associates, Inc. | Anesthesiology | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2010-04-28 |
| 1750607099 | Sean William Kaloostian | Neurological Surgery | 6276 River Crest Dr, Ste A, Riverside, CA 92507 | 2010-04-12 |
| 1457557100 | Babak Razaghi Khamsi | Orthopaedic Surgery | 6276 River Crest Dr, Riverside, CA 92507-0783 | 2007-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448917 | Rachel Nielson | Counselor | 1450 Spruce St, Suite A, Riverside, CA 92507 | 2020-08-24 |
| 1437769742 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 2862 Unit B Canyon Springs Parkway, Riverside, CA 92507 | 2020-08-03 |
| 1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
| 1164067567 | Audrey Gruen | Social Worker | Canyon Crest Mental Health, 5225 Canyon Crest Drive #100, Riverside, CA 92507 | 2019-11-10 |
| 1518432962 | Antonio Mixon | Specialist | 1405 Spruce Street, Suite A, Riverside, CA 92507 | 2018-10-11 |
| 1811479793 | New Day Counseling Services | Counselor | 20363 Harvard Way, Riverside, CA 92507 | 2018-09-06 |
| 1780176875 | Miriam Martinez | Case Manager/Care Coordinator | 2085 Rustin Ave., Riverside, CA 92507 | 2018-06-04 |
| 1518478874 | Lisa Manuel | Counselor | 2058 Rustin Ave, Riverside, CA 92507 | 2017-10-13 |
| 1497272942 | Yajaira Placensia | Behavioral Analyst | 1486 Everton Place, Riverside, CA 92507 | 2017-08-25 |
| 1841717691 | Stephanie Teuchert | Behavioral Analyst | 1080 Spruce Street Apartment 7c, Riverside, CA 92507 | 2017-08-23 |
| Find all providers in zip 92507 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558707075 | Jean M. Pouget | Family Medicine | 175 Northgate Rd, Riverside, Riverside, IL 60546-1683 | 2013-05-13 |
| 1730379082 | Charlotte Zane | Family Medicine | 4500 Riverwalk Parkway, Riverside, CA 92505-8247 | 2007-08-01 |
| 1972167112 | Belem Ureta | Family Medicine | 5870 Arlington Ave, Riverside, CA 92504-2037 | 2019-04-23 |
| 1063845972 | Lawrence B Sandberg | Family Medicine | 2880 Hulen Pl, Riverside, CA 92507-2606 | 2013-08-14 |
| 1760529176 | Roger G Annabel | Family Medicine | 11705 Slate Ave, #200, Riverside, CA 92505 | 2007-02-01 |
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|---|---|---|---|---|
| 1306446091 | Candace Maglinao | Family Medicine | 21010 Anza Ave Apt 12, Torrance, CA 90503-4254 | 2020-10-30 |
| 1942826797 | In-home Medical Mobile Services, Inc. | Family Medicine | 3400 E 8th St Ste 202, National City, CA 91950-3169 | 2020-06-17 |
| 1386269306 | Universal Mobile Doctors Inc | Family Medicine | 15333 Sherman Way Ste P, Van Nuys, CA 91406-4204 | 2020-06-16 |
| 1619597671 | Harry Eisenbach | Family Medicine | 9312 Smoketree Ln, Villa Park, CA 92861-1011 | 2020-04-20 |
| 1669092854 | Wellbeing Clinic Inc | Family Medicine | 1621 S New Hampshire Ave, Los Angeles, CA 90006-4513 | 2020-04-17 |
| 1619513611 | Krista Mckinney | Family Medicine | 344o E. La Palma Avenue, Anaheim, CA 92806 | 2019-11-25 |
| 1457995565 | Ucsf Medical Group Business Services | Family Medicine | 1100 Park Pl Ste 100, San Mateo, CA 94403-7119 | 2019-10-31 |
| 1780237313 | Charles Kim Md Inc | Family Medicine | 3055 W Orange Ave Ste 204, Anaheim, CA 92804-3154 | 2019-07-23 |
| 1083277206 | Baum 5 Star Healthcare | Family Medicine | 560 W Grangeville Blvd Ste A, Hanford, CA 93230-2858 | 2019-04-15 |
| 1477025278 | Connexus Family Clinic Inc | Family Medicine | 1930 E. Anaheim Street, N/a, Long Beach, CA 90813-3908 | 2018-12-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.