NPIMap

Organization Active NPI

Michael J. Sullivan MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1295736155
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
B1992003399 Issued in CA
Legal business name
MICHAEL J. SULLIVAN MD
Practice address
1835 El Cajon Blvd
Suite B
San Diego, CA 92103-2591
Phone
(619) 692-3977
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Authorized official

Name
Dr. Michael J Sullivan, M.D.NPI 1932100807
Title
Physician
Phone
(619) 692-3977

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X B1992003399 CA Primary

Addresses

Primary practice location

1835 El Cajon Blvd
Suite B
San Diego, CA 92103-2591

Mailing address

PO Box 638
Solana Beach, CA 92075-0638
Phone (619) 692-3977

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1295736155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920750638",
            "telephone_number": "619-692-3977",
            "fax_number": "619-692-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 EL CAJON BLVD",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032591",
            "telephone_number": "619-692-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. SULLIVAN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "619-692-3977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "B1992003399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.