Kyle Patrick Sullivan, C.O

Primary specialty

OrthotistTaxonomy code 222Z00000X

Practice address

4479 Stoneridge Dr
Suite a
Pleasanton, CA 94588-8448

Phone

(925) 484-6400

NPI assigned

Oct 16, 2007

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1669661641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4479 STONERIDGE DR",
            "address_2": "SUITE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888448",
            "telephone_number": "925-484-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4479 STONERIDGE DR",
            "address_2": "SUITE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888448",
            "telephone_number": "925-484-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KYLE",
        "middle_name": "PATRICK",
        "credential": "C.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandni Ayushyaman Suba, P.T.
• Nida Subhani, MD
• Ryan Suen, DC
• Amerind Sugiarto, M.S. CCC-SLP
• Kumar Sukhdeo, M.D., PH.D.
• Lynne Ann Sullivan, D.C.
• Marie De la Paz Sum, PSY.D.
• Summit Surgery Center LLC
• Chao Sun, M.D.
• Hongwei Sun, ACUPUNCTURIST

• Orthotist in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Orthotist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.