Dr. Theodore L Rudberg
Family Doctor - Geriatric Medicine
5430 E Sapphire Ln
Paradise Valley
, Arizona 85253-2533
Dr. Theodore L Rudberg
Family Doctor - Geriatric Medicine
5430 E Sapphire Ln
Paradise Valley
, Arizona 85253-2533
(602) 410-3293
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Theodore L Rudberg
- 5430 E Sapphire Ln
- Paradise Valley, AZ
- Zip : 85253-2533
- Phone : (602) 410-3293
Second Address
- Dr. Theodore L Rudberg
- 5430 E Sapphire Ln
- Paradise Valley, AZ
- Zip : 85253-2533
- Phone : (602) 410-3293
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | 11018 | AZ |
National Provider Identifier
| NPI | 1033100615 |
|---|---|
| Provider Name | Dr. Theodore L Rudberg |
| First Address | Paradise Valley, AZ 85253-2533 |
| Second Address | Paradise Valley, AZ 85253-2533 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/11/2005 |
| Last Update Date | 03/04/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0000BGJNC | (05) | AZ |
| 029229 | AM. BOARD OF FAMILY PRACT (01) | |
| D00218 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.