Individual
MARY M RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
321 MIDDLEFIELD RD, MENLO PARK, CA 94025-3500
(650) 498-6623
Mailing address
PO BOX 60000, FILE #72484, SAN FRANCISCO, CA 94160-0001
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
NP572
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MMM00087M
NHIC
—
Enumeration date
04/12/2006
Last updated
12/20/2011
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