Individual provider Active NPI

Bernard L Ullman, MD

  • Neurology Physician
  • Redondo Beach, CA
National Provider Identifier
1740359058
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G41380 Issued in CA
Practice address
520 N Prospect Avenue
Suite 309
Redondo Beach, CA 90277
Phone
(310) 376-9492
Fax
(310) 376-0848
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G41380 CA Primary

Addresses

Primary practice location

520 N Prospect Avenue
Suite 309
Redondo Beach, CA 90277

Mailing address

520 N Prospect Avenue
Suite 309
Redondo Beach, CA 90277
Phone (310) 376-9492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405001304 CA Practitioner - Neurology 7517914161 Reassigns benefits to 2 organizations
Practice locations: Torrance, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G41380CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Hospitalist Network Medical Group Inc CurrentSince Jan 10, 2011 Accepting new patients
Torrance Memorial Medical Center CurrentSince Jan 1, 2004 Accepting new patients
Torrance Memorial Medical Center CurrentSince Jan 1, 2004 Accepting new patients

Locations

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

520 N Prospect Ave
Ste 309
Redondo Beach, CA 90277
Phone (310) 376-9492

3330 Lomita Blvd
Torrance, CA 90505
Phone (310) 517-4675

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740359058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVENUE",
            "address_2": "SUITE 309",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90277",
            "telephone_number": "310-376-9492",
            "fax_number": "310-376-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVENUE",
            "address_2": "SUITE 309",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "90277",
            "telephone_number": "310-376-9492",
            "fax_number": "310-376-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLMAN",
        "first_name": "BERNARD",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G41380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.