MEDICARE: RICHARD H. LAUDE, M.D., INC.

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	2084P0800X	Psychiatry Physician	G31559	CA

General Provider Information

NPI Number	:	1588708002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD H. LAUDE, M.D., INC.

Provider Business Mailing Address
First Line	:	4370 ALPINE RD
Second Line	:	SUITE 105
City	:	PORTOLA VALLEY
State	:	CA
Zip	:	94028-7952
Country	:	US
Telephone Number	:	650-851-0226
Fax Number	:	650-329-1954

Provider Business Practice Location Address
First Line	:	4370 ALPINE RD
Second Line	:	SUITE 105
City	:	PORTOLA VALLEY
State	:	CA
Zip	:	94028-7952
Country	:	US
Telephone Number	:	650-851-0226
Fax Number	:	650-329-1954

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD HORTON LAUDE
Credential	:	M.D.
Telephone Number	:	650-851-0226

Provider Enumeration Date	:	02/17/2007
Last Update Date	:	08/22/2020

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