Individual provider Active NPI

Steven P Cullen, MD

  • Internal Medicine Physician
  • San Clemente, CA
National Provider Identifier
1487765731
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G77691 Issued in CA
Practice address
665 Camino de Los Mares Ste 309
San Clemente, CA 92673
Phone
(949) 487-9034
Fax
(949) 493-3721
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G77691 CA Primary

Addresses

Primary practice location

665 Camino de Los Mares Ste 309
San Clemente, CA 92673

Mailing address

665 Camino de Los Mares Ste 309
San Clemente, CA 92673-2841
Phone (949) 487-9034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090604000042 CA Practitioner - Internal Medicine 2668404104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northwestern University Feinberg Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Clemente Internal Medical Group IncGroup PAC ID 8022044718, 2 clinicians

Practice addresses (Care Compare)

665 Camino de Los Mares
Suite 309
San Clemente, CA 92673-2841
Phone (949) 487-9034

Hospital & facility affiliations

  • Acacia HH&P of Southern California, LLC Home health agency, Irvine, CA, CCN 559093
  • Acacia Home Health Services Home health agency, Glendale, CA, CCN 059256
  • Acacia Hospice and Palliative Services Hospice, Irvine, CA, CCN 921664
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • San Juan Hills Healthcare Center Nursing home, San Juan Capistrano, CA, CCN 555763

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions36
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
San Clemente Internal Medical Group Inc. Internal Medicine CurrentSince Feb 1, 2003 Accepting new patients

Locations

665 Camino de los Mares
Ste 309
San Clemente, CA 92673
Phone (949) 487-9034

Organizations & group practices 1

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1487765731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 CAMINO DE LOS MARES STE 309",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732841",
            "telephone_number": "949-487-9034",
            "fax_number": "949-493-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 CAMINO DE LOS MARES STE 309",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-487-9034",
            "fax_number": "949-493-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "STEVEN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G77691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.