MR. CHARLES N RUDOLPH (NPI# 1386636348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386636348 |
| Entity Type | Individual |
| Full Name | MR. CHARLES N RUDOLPH |
| Credential | MD |
| Practice Address |
4510 Executive Drive Suite 125 San Diego CA 92121 |
| Practice Telephone | 8586780455 |
| Practice Fax Number | 8586780391 |
| Mailing Telephone | 8586780455 |
| Mailing Fax Number | 8586780391 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2011-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | G60659 | CA | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | G60659 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497831267 | Charles John Rudolph Jr. | General Practice | 2800 Kendallwood Parkway, Suite A, Kansas City, MO 64119 | 2006-10-27 |
| 1346351673 | Charles Todd Rudolph | Internal Medicine | 170 Mouse Creek Rd Nw, Cleveland, TN 37312-3840 | 2006-08-31 |
| 1821047853 | Charles Rudolph IIi | Optometrist | 8600 Ward Pkwy, #710, Kansas City, MO 64114-2614 | 2006-05-08 |
| 1871527135 | Charles E Rudolph | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-07-10 |
| Street Address |
4510 EXECUTIVE DRIVE SUITE 125 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629628730 | Hannah Rovazzini | Marriage & Family Therapist | 4510 Executive Drive, San Diego, CA 92121 | 2019-09-19 |
| 1619111440 | Gabriel Schnickel | Transplant Surgery | 4510 Executive Drive, Plaza 7, San Diego, CA 92121-3021 | 2009-04-23 |
| 1972710663 | Kambiz Kohani | Dentist | 4510 Executive Drive, Suite #205, San Diego, CA 92121 | 2007-05-16 |
| 1356401566 | Bonebuilders Medical Clinic | Orthopaedic Surgery | 4510 Executive Drive, Suite 125, San Diego, CA 92121 | 2006-12-11 |
| 1205885902 | Kevin Wayne Broder | Plastic Surgery | 4510 Executive Drive, Suite 200, San Diego, CA 92121 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225650187 | Jb Ortho, Inc. | Orthopaedic Surgery | 4060 Fourth Ave Ste 630, San Diego, CA 92103-2118 | 2020-05-14 |
| 1962794198 | William Kent | Orthopaedic Surgery | 200 W Arbor Dr., San Diego, CA 92103 | 2011-05-05 |
| 1194014258 | Jaysson Trevor Brooks | Orthopaedic Surgery | 3030 Childrens Way Fl 3, San Diego, CA 92123-4232 | 2011-03-29 |
| 1821227463 | Robert K. Eastlack Md Inc | Orthopaedic Surgery | 5265 Amber View Pt, San Diego, CA 92130-6933 | 2009-07-03 |
| 1568627602 | Adam M Holleran | Orthopaedic Surgery | 2930 Barnard St Unit 7301, San Diego, CA 92110-5729 | 2008-07-28 |
| 1356505705 | Michael Lucius Pomerantz | Orthopaedic Surgery | 4445 Eastgate Mall Ste 105, San Diego, CA 92121 | 2008-07-15 |
| 1962660928 | Nilofar Faghihnia | Orthopaedic Surgery | 425 W Beech St Unit 1306, San Diego, CA 92101-2961 | 2008-05-27 |
| 1700074127 | Jeremy Bell Mccandless | Orthopaedic Surgery | 4060 4th Ave Ste 700, San Diego, CA 92103-2121 | 2007-10-10 |
| 1043418759 | Oke Adrian Anakwenze | Orthopaedic Surgery | 3750 Convoy St Ste 201, San Diego, CA 92111-3770 | 2007-07-03 |
| 1205996097 | Harish Sadanand Hosalkar | Orthopaedic Surgery | 15151 Almond Orchard Ln, San Diego, CA 92131-4328 | 2006-12-11 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.