Dr. Russell Leonard Sandberg
Internist - Addiction Medicine
1466 Lincoln Ave
San Rafael
, California 94901-2021
Dr. Russell Leonard Sandberg
Internist - Addiction Medicine
1466 Lincoln Ave
San Rafael
, California 94901-2021
(415) 456-1649
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About
Features
Specialties
- Internist - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. Russell Leonard Sandberg
- 433 The Alameda
- San Anselmo, CA
- Zip : 94960-1210
- Fax : (415) 456-1649
- Phone : (415) 456-1649
Second Address
- Dr. Russell Leonard Sandberg
- 1466 Lincoln Ave
- San Rafael, CA
- Zip : 94901-2021
- Fax : (415) 457-0849
- Phone : (415) 457-3755
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0401X | Internist - Addiction Medicine | G26538 | CA |
National Provider Identifier
| NPI | 1265522528 |
|---|---|
| Provider Name | Dr. Russell Leonard Sandberg |
| First Address | San Anselmo, CA 94960-1210 |
| Second Address | San Rafael, CA 94901-2021 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/10/2006 |
| Last Update Date | 01/12/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G265381 | (05) | CA |
| G26538 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.