Rendon, Raymond Rudolph

Rendon, Raymond Rudolph is an individual health care provider with primary practice located at 2039 Forest Ave Ste 206 , San Jose CA 95128-4815. He recently has only one registered license in Other Service Providers / Prosthetics Case Management, which is considered as his primary health care specialty. Rendon, Raymond Rudolph can be contacted via phone (408) 297-4850.

Contact Information

Primary practice address
2039 Forest Ave Ste 206 San Jose CA 95128-4815
Phone: (408) 297-4850
Fax: (408) 297-0676
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Prosthetics Case Management 1744P3200X

Profile Details

NPI number 1710097613
LBN Legal business name Rendon, Raymond Rudolph
Credentials B.C.O.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Mar 5th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710097613 NPPES
California MEDICAID DXX00008F

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