Provider Demographics
NPI:1972873727
Name:RICHARDS, RUFUS HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:RUFUS
Middle Name:HENRY
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R HENRY
Other - Middle Name:
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:15466 LOS GATOS BLVD
Mailing Address - Street 2:SUITE 109-066
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2556
Mailing Address - Country:US
Mailing Address - Phone:408-896-2052
Mailing Address - Fax:
Practice Address - Street 1:15466 LOS GATOS BLVD
Practice Address - Street 2:SUITE 109-066
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2556
Practice Address - Country:US
Practice Address - Phone:408-896-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22806207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG55806OtherMEDICAL BOARD OF CALIFORNIA
VA0101050935OtherCOMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
TNMD0000025342OtherSTATE OF TENNESSEE DIVISION OF HEALTH RELATED SERVICES