Sullivan, Terrence R
Sullivan, Terrence R is an sole proprietor health care provider with primary practice located at 16450 Matilija Dr , Los Gatos CA 95030-3080. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Sullivan, Terrence R can be contacted via phone (408) 590-3159.Contact Information
Primary practice address
16450 Matilija Dr
Los Gatos CA 95030-3080
Phone: (408) 590-3159
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | G25099 | California |
Profile Details
| NPI number | 1447244785 |
|---|---|
| LBN Legal business name | Sullivan, Terrence R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 1st, 2005 |
| Last updated | Oct 24th, 2023 - about last year |
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 | 1447244785 | NPPES |
| Other | P00061715 | RAILROAD MEDICARE |
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