Provider Demographics
NPI:1013116433
Name:RASSEL, RUTH ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:ANN
Last Name:RASSEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2 MARIPOSA CT
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-2017
Mailing Address - Country:US
Mailing Address - Phone:415-272-1131
Mailing Address - Fax:415-435-5064
Practice Address - Street 1:2 MARIPOSA CT
Practice Address - Street 2:
Practice Address - City:TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920-2017
Practice Address - Country:US
Practice Address - Phone:415-272-1131
Practice Address - Fax:415-435-5064
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9890208600000X
IL36116771208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery