Individual provider Active NPI

Teejay Cacpal Rull, PA-C, MPH

  • Physician Assistant
  • Lynwood, CA
National Provider Identifier
1154724987
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 51730 Issued in CA
Practice address
3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone
(310) 900-8900
NPI assigned
Oct 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 51730 CA Primary

Addresses

Primary practice location

3630 E Imperial Hwy
Lynwood, CA 90262-2609

Mailing address

3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone (310) 900-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150126001403 CA Practitioner - Physician Assistant 8628392446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care of California a Medical CorporationGroup PAC ID 5799854303, 135 clinicians

Practice addresses (Care Compare)

740 Nordahl Rd
Suite 131
San Marcos, CA 92069-3545
Phone (760) 432-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51730CAMDGeneral Practice Dentistry
PA 51730CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of California, a Medical Corporation CurrentSince Oct 26, 2017 Accepting new patients
American Current Care of California, a Medical Corporation CurrentSince Oct 26, 2017 Accepting new patients
Cep America - California CurrentSince Jul 1, 2015 Accepting new patients
Front Line Emergency Care Spec Past Accepting new patients

Locations

1800 Westwind Dr
Ste 301
Bakersfield, CA 93301
Phone (661) 327-9617

2555 S East Ave
Fresno, CA 93706
Phone (559) 499-2400

6033 W Century Blvd
Ste 200
Los Angeles, CA 90045
Phone (310) 215-1600

3630 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 900-7420

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

640 S Placentia Ave
Placentia, CA 92870
Phone (714) 579-7772

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055

2587 Merced St
San Leandro, CA 94577
Phone (510) 351-3553

740 Nordahl Rd
Ste 131
San Marcos, CA 92069
Phone (760) 432-9000

1221 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 543-8360

3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500

21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1154724987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULL",
        "first_name": "TEEJAY",
        "middle_name": "CACPAL",
        "name_prefix": "Mr.",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 51730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.