Active NPI
David S. Ruderman, M.D.
- Psychiatry Physician
- Torrance, CA
National Provider Identifier
1235201377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G43326
- Practice address
- 22330 Hawthorn Blvd
Suite 212
Torrance, CA 90505 - Phone
- (310) 534-8110
- Fax
- (310) 519-8388
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G43326 | CA | Primary |
Addresses
Primary practice location
22330 Hawthorn Blvd
Suite 212
Torrance, CA 90505
Mailing address
1379 Park Western Dr
# 308
San Pedro, CA 90732-2300
Phone (310) 784-7224
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 29, 2016 through Mar 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43326 | CA | MD | Dentist |
| G43326 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1235201377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1379 PARK WESTERN DR",
"address_2": "# 308",
"city": "SAN PEDRO",
"state": "CA",
"postal_code": "907322300",
"telephone_number": "310-784-7224",
"fax_number": "310-519-8388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22330 HAWTHORN BLVD",
"address_2": "SUITE 212",
"city": "TORRANCE",
"state": "CA",
"postal_code": "90505",
"telephone_number": "310-534-8110",
"fax_number": "310-519-8388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDERMAN",
"first_name": "DAVID",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G43326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.