Provider Demographics
NPI:1922123926
Name:RUDE, LOREN D (OD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:D
Last Name:RUDE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4300 LONG BEACH BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2008
Mailing Address - Country:US
Mailing Address - Phone:562-591-7700
Mailing Address - Fax:562-591-1311
Practice Address - Street 1:4300 LONG BEACH BLVD STE 400
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2008
Practice Address - Country:US
Practice Address - Phone:562-591-7700
Practice Address - Fax:562-591-7700
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11568T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist