Provider Demographics
NPI:1447924394
Name:RUDHMAN, MEREDITH LEIGH
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LEIGH
Last Name:RUDHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W TEMPLE ST FL 19
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3231
Mailing Address - Country:US
Mailing Address - Phone:213-926-9825
Mailing Address - Fax:
Practice Address - Street 1:210 W TEMPLE ST FL 19
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3231
Practice Address - Country:US
Practice Address - Phone:213-926-9825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator