MEDICARE: DR. NICHOLE RUFFNER 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
1	207V00000X	Obstetrics & Gynecology Physician	264191-1	NY

General Provider Information

NPI Number	:	1386906428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLE RUFFNER 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	:	415-750-7050
Fax Number	:	415-369-1389

Provider Business Practice Location Address
First Line	:	1100 VAN NESS AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6978
Country	:	US
Telephone Number	:	415-750-7050
Fax Number	:	415-369-1389

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2012
Last Update Date	:	12/17/2025

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Directions to “ DR. NICHOLE RUFFNER M.D.” Practice Location

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