Bullock, Robert
Bullock, Robert is an individual health care provider with primary practice located at 5555 Grossmont Center Dr , La Mesa CA 91942. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Bullock, Robert can be contacted via phone (619) 460-5111.Contact Information
Primary practice address
5555 Grossmont Center Dr
La Mesa CA 91942
Phone: (619) 460-5111
Fax: (619) 460-7815
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | G12026 | California |
Profile Details
| NPI number | 1912065111 |
|---|---|
| LBN Legal business name | Bullock, Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912065111 | NPPES |
| California | MEDICAID | 00G120260 |
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