Individual
DR. ROSS RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-8991
Mailing address
FILE# 54433, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
G29569
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G295690
—
CA
Enumeration date
04/19/2006
Last updated
06/29/2009
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