Individual provider Active NPI

Ornella J Rullo, M.D.

  • Pediatric Rheumatology Physician
  • Los Angeles, CA
National Provider Identifier
1720317753
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
A90828 Issued in CA
Practice address
10833 Le Conte Ave
MDCC 12-430
Los Angeles, CA 90095-1752
Phone
(310) 825-6481
Fax
(310) 825-9832
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X A90828 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
MDCC 12-430
Los Angeles, CA 90095-1752

Mailing address

10833 Le Conte Ave
MDCC 12-430
Los Angeles, CA 90095-1752
Phone (310) 825-6481

Other identifiers 1

IdentifierTypeStateIssuer
00A908280MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1720317753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "MDCC 12-430",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951752",
            "telephone_number": "310-825-6481",
            "fax_number": "310-825-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "address_2": "MDCC 12-430",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951752",
            "telephone_number": "310-825-6481",
            "fax_number": "310-825-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULLO",
        "first_name": "ORNELLA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "CA",
            "license": "A90828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A908280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.