Kevin Cullen

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

0041750 Issued in CA

Practice address

3206 W Balboa Blvd
Newport Beach, CA 92663-3018

Phone

(949) 723-2388

Fax

(949) 723-1288

NPI assigned

Aug 8, 2012

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Balboa Recovery

  dba Oceans Sober Living

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Newport Beach, CA
  • NPI 1346619046
  Authorized official Same address or phone
• Balboa Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Newport Beach, CA
  • NPI 1730436809
  NPD (past) Authorized official
• Balboa Recovery

  • Point of Service
  • Newport Beach, CA
  • NPI 1982957197
  Authorized official Same address or phone

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1407103567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 VIA LIDO",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633908",
            "telephone_number": "949-723-2388",
            "fax_number": "949-723-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 W BALBOA BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633018",
            "telephone_number": "949-723-2388",
            "fax_number": "949-723-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "0041750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoltan Csuka, MD
• Kellie Cuadras, LMFT
• Marc Gregory Cubeiro, MD
• Kiley Cuene
• Ben Culhane
• Michael Dale Cully, MD
• Amanda Sandra Culwell
• David R. Cummings, D.D.S.
• Chelsea Nicole Cunanan, PTA
• John Cupp

• Point of Service in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.

Verify at the official NPI Registry.