Active NPI
Bruce L. Hultgren, MD
- Anesthesiology Physician
- Monterey, CA
National Provider Identifier
1285734988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G25121
- Practice address
- 23625 WR Holman Hwy
Monterey, CA 93940-5902 - Phone
- (831) 624-5311
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD-9731 | HI | |
| Anesthesiology Physician | 207L00000X | G25121 | CA | Primary |
Addresses
Primary practice location
23625 WR Holman Hwy
Monterey, CA 93940-5902
Mailing address
PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080464-01 | Medicaid | HI | |
| 0000210195 | Other | HI | HMSA BILLING NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1285734988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7096",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952670096",
"telephone_number": "209-956-7725",
"fax_number": "209-956-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23625 WR HOLMAN HWY",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939405902",
"telephone_number": "831-624-5311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HULTGREN",
"first_name": "BRUCE",
"middle_name": "L.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "HI",
"license": "MD-9731",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G25121",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "080464-01",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA BILLING NUMBER",
"identifier": "0000210195",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monterey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.