MEDICARE: MR. RUVI DHADDEY J.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	171W00000X	Contractor

General Provider Information

NPI Number	:	1467797852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUVI DHADDEY J.D.

Provider Business Mailing Address
First Line	:	1132 COLE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-4320
Country	:	US
Telephone Number	:	415-742-4745
Fax Number	:	415-742-4745

Provider Business Practice Location Address
First Line	:	4 EMBARCADERO CTR
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-4106
Country	:	US
Telephone Number	:	415-742-4745
Fax Number	:	415-742-4745

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

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	12/11/2012

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