Active NPI
John Timothy Culbreath, PA-C
- Physician Assistant
- San Jose, CA
National Provider Identifier
1558725176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 14532
- Practice address
- 2581 Samaritan Dr Ste 202
San Jose, CA 95124-4112 - Phone
- (408) 358-3939
- Fax
- (408) 490-2849
- NPI assigned
- Apr 9, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 14532 | CA | Primary |
Addresses
Primary practice location
2581 Samaritan Dr Ste 202
San Jose, CA 95124-4112
Mailing address
3270 Longview Dr
San Bruno, CA 94066-1648
Phone (650) 703-3508
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 14532 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460160000000",
"number": "1558725176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3270 LONGVIEW DR",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940661648",
"telephone_number": "650-703-3508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2581 SAMARITAN DR STE 202",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951244112",
"telephone_number": "408-358-3939",
"fax_number": "408-490-2849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULBREATH",
"first_name": "JOHN",
"middle_name": "TIMOTHY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-09",
"last_updated": "2016-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 14532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.