Adele Marie O'Sullivan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15677 Issued in AZ

Practice address

11999 Chalon Rd
Los Angeles, CA 90049-1524

Phone

(310) 889-2153

Fax

(310) 472-5982

NPI assigned

May 23, 2006

Last updated

Jun 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1568417053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 CHALON RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900491524",
            "telephone_number": "310-889-2153",
            "fax_number": "310-472-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11999 CHALON RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900491524",
            "telephone_number": "310-889-2153",
            "fax_number": "310-472-5982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 South 12th Avenue",
            "address_2": "Maricopa County Health Care for the Homeless",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85007",
            "country_code": "US",
            "telephone_number": "602-372-2102",
            "fax_number": "602-372-2120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 S 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850073101",
            "country_code": "US",
            "telephone_number": "602-776-9000",
            "fax_number": "602-776-9001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 W Indian School Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850133205",
            "country_code": "US",
            "telephone_number": "602-776-9000",
            "fax_number": "602-776-9001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "ADELE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "15677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275299",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Caroline F Oak, PHARM.D.

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.