Active NPI
Nicholas Dean Gutlay Bullo, DC
- Chiropractor
- Irvine, CA
National Provider Identifier
1831958842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 36909
- Practice address
- 1 Peters Canyon Rd Ste 120
Irvine, CA 92606-1748 - Phone
- (949) 229-2451
- NPI assigned
- Mar 14, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 36909 | CA | Primary |
Addresses
Primary practice location
1 Peters Canyon Rd Ste 120
Irvine, CA 92606-1748
Mailing address
22811 Date Ave
Torrance, CA 90505-3028
Phone (310) 619-6624
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36909 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1831958842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22811 DATE AVE",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905053028",
"telephone_number": "310-619-6624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PETERS CANYON RD STE 120",
"city": "IRVINE",
"state": "CA",
"postal_code": "926061748",
"telephone_number": "949-229-2451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULLO",
"first_name": "NICHOLAS DEAN",
"middle_name": "GUTLAY",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-14",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "36909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.