Culinary Extra Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CULINARY EXTRA CLINIC

Practice address

1961 Las Vegas Blvd S Ste 101
Las Vegas, NV 89104-1310

Phone

(702) 852-0215

NPI assigned

Aug 15, 2014

Organization subpart

No

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

Authorized official

Name

Rushika Fernandopulle, MD

Title

Ceo

Phone

(617) 454-4672

Specialties & licenses 1

Addresses

Tax ID family

Culinary Extra Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Rushika Fernandopulle (Iora Nevada), P.C.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1386195246
  NPD tax ID
• Turntable Health

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1740689579
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Praveen Jayakumar, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1235337486
  NPD (past)

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1801295712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TREMONT ST FL 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021085004",
            "telephone_number": "617-454-4672",
            "fax_number": "617-701-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 LAS VEGAS BLVD S STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041310",
            "telephone_number": "702-852-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULINARY EXTRA CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "FERNANDOPULLE",
        "authorized_official_first_name": "RUSHIKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-454-4672",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maylene Rosanes Culanag, APRN-CNP
• Rosemarie Culanay
• Lakeia Culberson
• Emily Christina Culbert, M.D.
• Darious Culepepper
• Charles Cody Cull, DPM
• Gina Cullen
• Laura Krugman Culley, M.D.
• Yolanda Cullins
• Ryan Cullo

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.