John David Culbertson, MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JOHN DAVID CULBERTSON, MD INC

Practice address

895 Sir Francis Drake Blvd
San Anselmo, CA 94960-1916

Phone

(415) 925-3617

Fax

(415) 925-3597

NPI assigned

Jan 27, 2025

Organization subpart

No

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

Authorized official

Name

Dr. John David Culbertson, MDNPI 1649219833

Title

President/Owner

Phone

(415) 925-3617

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John David Culbertson, M.D.

  • Internal Medicine Physician
  • San Anselmo, CA
  • NPI 1649219833
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1295548105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6671",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954060671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 SIR FRANCIS DRAKE BLVD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601916",
            "telephone_number": "415-925-3617",
            "fax_number": "415-925-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN DAVID CULBERTSON, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "CULBERTSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "415-925-3617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.