Ryan Douglas Bullock, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

Practice address

1360 W 6TH St Ste 243
San Pedro, CA 90732-3589

Phone

(424) 570-0117

Fax

(424) 570-0499

NPI assigned

Oct 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Harbor Hearing Services, Professional Corporation

  • Audiologist
  • San Pedro, CA
  • NPI 1568947430
  Medicare reassignment NPD Authorized official
• South Bay Hearing & Balance Center

  • Audiologist-Hearing Aid Fitter
  • Mission Viejo, CA
  • NPI 1780022624
  NPD (past)

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1184976409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MONTEREY BLVD APT 10",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902544583",
            "telephone_number": "479-459-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST STE 243",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323589",
            "telephone_number": "424-570-0117",
            "fax_number": "424-570-0499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11201 NE 9th St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986845964",
            "country_code": "US",
            "telephone_number": "479-459-2261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "RYAN",
        "middle_name": "DOUGLAS",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-10",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Lawrance Brown
• Alida Brscic-Biasi, D.D.S.
• Bruce D. Levine, D.P.M., Professional Corporation
• James Steven Brust, M.D.
• Aiken K Bui, RPH
• Charis Mae T. Bulosan
• Yesenia Burgos
• Jack Neelan Burns Jr., D.C.
• Jessica Cabrera, MSN, RN, AGACNP-BC
• Erica Cachu

• Audiologist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.