Bullock, Todd
Bullock, Todd is an sole proprietor health care provider with primary practice located at 138 Joerschke Dr , Grass Valley CA 95945-5248. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bullock, Todd can be contacted via phone (530) 477-1004.Contact Information
Primary practice address
138 Joerschke Dr
Grass Valley CA 95945-5248
Phone: (530) 477-1004
Fax: (530) 477-0809
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X |
Profile Details
| NPI number | 1700888047 |
|---|---|
| LBN Legal business name | Bullock, Todd |
| Credentials | C.P.O |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Sep 22nd, 2020 - about 4 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 | 1700888047 | NPPES |
| California | MEDICAID | XB0025770 |
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