Provider Demographics
NPI:1255410718
Name:RICHARD HELMUT ROLFES DPM
Entity type:Organization
Organization Name:RICHARD HELMUT ROLFES DPM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HELMUT
Authorized Official - Last Name:ROLFES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:415-731-6700
Mailing Address - Street 1:595 BUCKINGHAM WAY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1909
Mailing Address - Country:US
Mailing Address - Phone:415-731-6700
Mailing Address - Fax:415-759-8637
Practice Address - Street 1:595 BUCKINGHAM WAY
Practice Address - Street 2:SUITE 330
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1909
Practice Address - Country:US
Practice Address - Phone:415-731-6700
Practice Address - Fax:415-759-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE33030213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1528098878OtherNPI - INDIVIDUAL
CA1528099439OtherNPI - INDIVIDUAL
000E12390Medicare PIN
T10850Medicare UPIN
CA1528099439OtherNPI - INDIVIDUAL
T11622Medicare UPIN
ZZZ14868ZMedicare PIN
CA1528098878OtherNPI - INDIVIDUAL