Carolyn Bullard Yardimian, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT37123 Issued in CA

Practice address

886 Magnolia Ave
Ste. 100
Corona, CA 92879-3105

Phone

(951) 340-3402

Fax

(951) 340-3416

NPI assigned

Aug 30, 2010

Last updated

Dec 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carolyn Corinne Bullard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Rancho Physical Therapy, Inc.

  • Physical Therapist
  • Corona, CA
  • NPI 1891763561
  NPD (past)

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1164738076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE",
            "address_2": "STE. 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 MAGNOLIA AVE",
            "address_2": "STE. 100",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793105",
            "telephone_number": "951-340-3402",
            "fax_number": "951-340-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARDIMIAN",
        "first_name": "CAROLYN",
        "middle_name": "BULLARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT37123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "0PT371230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "BULLARD",
            "middle_name": "CORINNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Yang, M.D.
• Junghee Yang, LAC
• Meihui Yang
• Seung C Yang, MD
• Liezel Joy L Yao
• Babak Yasmeh, M.D.
• Ayten Yatim
• Jaclyn Ybarra
• Ariana Yea, PA-C
• Gordon Gar Kwong Yee, MD

• Physical Therapist in Corona, CA
• Providers in Corona, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.