Provider Demographics
NPI:1598763138
Name:NUDEL, BELLA I (MD)
Entity Type:Individual
Prefix:MRS
First Name:BELLA
Middle Name:I
Last Name:NUDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2320 SUTTER ST
Mailing Address - Street 2:STE 101
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3038
Mailing Address - Country:US
Mailing Address - Phone:415-928-2110
Mailing Address - Fax:415-928-1311
Practice Address - Street 1:2320 SUTTER ST
Practice Address - Street 2:STE 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3038
Practice Address - Country:US
Practice Address - Phone:415-928-2110
Practice Address - Fax:415-928-1311
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA044416208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A444160Medicaid
CA00A444160Medicaid
F02359Medicare UPIN