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General NPI Number Information
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NPI Number | 1306119052
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Entity Type | Organization
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Legal Business Name | BRIAN D. RUDIN, M.D., INC.
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 696 HAMPSHIRE ROAD SUITE 180
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-285-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 1014 S WESTLKE BLVD PMB 14 171
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-285-2225
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. BRIAN D RUDIN
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Credential | MD
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Telephone | 805-285-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | A75433
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License Number State | CA
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