Donna L Tully, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2003-0035 Issued in NM

Practice address

1179 N McDowell Blvd
Petaluma, CA 94954-6559

Phone

(707) 559-7500

Fax

(707) 559-7570

NPI assigned

Nov 7, 2005

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

Physician Assistant

Practice roles

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.

• Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Oakland, CA
  • NPI 1508874454
  NPD (past)
• Berkeley Emergency Medical Group, Inc.

  • Emergency Medicine Physician
  • Berkeley, CA
  • NPI 1780692632
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393632000000",
    "number": "1699756809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546559",
            "telephone_number": "707-559-7500",
            "fax_number": "707-559-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLY",
        "first_name": "DONNA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2014-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2003-0035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25486080",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• An Truong, MS, ATC, CSCS D
• Cindy Thi Truong, PHARM.D
• Dao C Truong, D.C.
• Darwin C Tsang, O.D.
• Ho Lam Tsang, LAC
• Kaylin Turk
• Barbara Ann Turner, PHD, MFT
• Harold Turner
• Melissa C Umemoto-Snyder
• Unilab Corporation

• Physician Assistant in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.