NPIMap

Organization Active NPI

Mark R. Pulera, MD, a Professional Corporation

  • Neurology Physician
  • Marina del Rey, CA
National Provider Identifier
1811034135
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G081695 Issued in CA
Legal business name
MARK R. PULERA, MD, A PROFESSIONAL CORPORATION
Practice address
4644 Lincoln Blvd
Suite 404
Marina del Rey, CA 90292-6313
Phone
(310) 823-7800
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Authorized official

Name
Mark Ronald Pulera, MD
Title
President
Phone
(310) 823-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X G081695 CA Primary

Addresses

Primary practice location

4644 Lincoln Blvd
Suite 404
Marina del Rey, CA 90292-6313

Mailing address

4644 Lincoln Blvd
Suite 404
Marina del Rey, CA 90292-6313
Phone (310) 823-7800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1811034135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "SUITE 404",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-823-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 LINCOLN BLVD",
            "address_2": "SUITE 404",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926313",
            "telephone_number": "310-823-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R. PULERA, MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "PULERA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-823-7800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G081695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; 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.