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Individual

DR. COLIN DAVID RUDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
156 PARKER AVENUE, SAN FRANCISCO, CA 94118-2608
(415) 317-6342
Mailing address
156 PARKER AVENUE, SAN FRANCISCO, CA 94118-2608
(415) 317-6342

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
42936
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004006261W
HUMANA
05
34045500
WI
Enumeration date
05/12/2006
Last updated
01/03/2022
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