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DR. RUSSELL NORMAN COTTERAL OD

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1619911047

Individual Registrant:
DR. RUSSELL NORMAN COTTERAL OD
Gender: M
Sole Proprietor

Location and contact information for practice:
396 COLUSA AVE  KENSINGTON, CA 94707-1209 US
Tel: 510-527-1714  Fax: 510-527-1715

Contact information for business:
396 COLUSA AVE  KENSINGTON, CA 94707-1209 US
Tel: 510-527-1714  Fax: 510-527-1715

Registration Information:
NPI: 1619911047
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
CA9134

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICAL EYE SERVICES12452CA01




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