Healthcare Provider Details

I. General information

NPI: 1598763138
Provider Name (Legal Business Name): BELLA I NUDEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 11/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 SUTTER ST STE 101
SAN FRANCISCO CA
94115-3038
US

IV. Provider business mailing address

2320 SUTTER ST STE 101
SAN FRANCISCO CA
94115-3038
US

V. Phone/Fax

Practice location:
  • Phone: 415-928-2110
  • Fax: 415-928-1311
Mailing address:
  • Phone: 415-928-2110
  • Fax: 415-928-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA044416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: