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General NPI Number Information
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NPI Number | 1659502201
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Entity Type | Individual
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Provider Name | ANTHONY JOSEPH RUDICK O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 5889 CLARK RD
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City | PARADISE
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State | CA
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Zip | 95969-4861
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Country | US
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Telephone | 530-877-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 BRUCE RD
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City | CHICO
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State | CA
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Zip | 95928-7941
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Country | US
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Telephone | 530-891-1900
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Fax | 530-895-1531
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13746
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License Number State | CA
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