Provider Demographics
NPI:1316159932
Name:RUSKIN, ROBERT BRUCE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRUCE
Last Name:RUSKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:174 WALTER HAYS DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-2923
Mailing Address - Country:US
Mailing Address - Phone:650-326-8527
Mailing Address - Fax:650-853-1668
Practice Address - Street 1:795 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2302
Practice Address - Country:US
Practice Address - Phone:650-326-8527
Practice Address - Fax:650-853-1668
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC031625207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology