Individual provider Active NPI

Anica Bulic, MD

  • Pediatric Cardiology Physician
  • Palo Alto, CA
National Provider Identifier
1699053298
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A128050 Issued in CA
Practice address
750 Welch Rd
Suite 325
Palo Alto, CA 94304-1507
Phone
(650) 736-8716
Fax
(650) 725-8343
NPI assigned
Jul 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Cardiology Physician 2080P0202X A128050 CA Primary

Addresses

Primary practice location

750 Welch Rd
Suite 325
Palo Alto, CA 94304-1507

Mailing address

750 Welch Rd
Suite 325
Palo Alto, CA 94304-1507
Phone (650) 736-8716

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A128050CAMDPediatric Cardiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1311984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1699053298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WELCH RD",
            "address_2": "SUITE 325",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041507",
            "telephone_number": "650-736-8716",
            "fax_number": "650-725-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELCH RD",
            "address_2": "SUITE 325",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041507",
            "telephone_number": "650-736-8716",
            "fax_number": "650-725-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULIC",
        "first_name": "ANICA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-30",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A128050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.