Charles N Rudolph, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G60659 Issued in CA

Practice address

4150 Regents Park Row Ste 321
La Jolla, CA 92037-9124

Phone

(858) 678-0455

Fax

(858) 678-0391

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: crudolph43340@scrippshlth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1386636348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DRIVE",
            "address_2": "SUITE 125",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "858-678-0455",
            "fax_number": "858-678-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 REGENTS PARK ROW STE 321",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379124",
            "telephone_number": "858-678-0455",
            "fax_number": "858-678-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "CHARLES",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G60659",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G60659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David S. Rubenson, M.D.
• Elka Rubin, MD
• Lewis J Rubin, M.D.
• Lisa Amy Ruderman, MA MFT
• Steven R Ruderman, MD
• Ross Rudolph, M.D.
• Mariel Ruiz Stasiuk
• Jose Luis Ruiz, P.A.
• Jennifer Rumsey, APRN, FNP-BC, DNP
• Julie Rumsey

• Orthopaedic Surgery Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.