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NPI Code Detail

MEDICARE: MICHAEL ALLEN RUDER M.D.

MEDICARE: MICHAEL ALLEN RUDER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207UN0901XNuclear Cardiology PhysicianG52891CA
2207RC0000XCardiovascular Disease PhysicianG52891CA

General Provider Information

NPI Number : 1679506208
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ALLEN RUDER M.D.
Provider Business Mailing Address
First Line : 325 DISTEL CIR
Second Line :
City : LOS ALTOS
State : CA
Zip : 94022-1408
Country : US
Telephone Number : 650-817-8100
Fax Number :
Provider Business Practice Location Address
First Line : 1950 UNIVERSITY AVE
Second Line : SUITE 160
City : E PALO ALTO
State : CA
Zip : 94303-2250
Country : US
Telephone Number : 650-617-8100
Fax Number : 650-327-2947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2006
Last Update Date : 05/28/2020

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Directions to “ MICHAEL ALLEN RUDER M.D.” Practice Location

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