Robert Bullock, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G12026 Issued in CA

Practice address

5555 Grossmont Center Dr
La Mesa, CA 91942

Phone

(619) 460-5111

Fax

(619) 460-7815

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• San Diego Anesthesia Consulting GRP Inc

  • Specialist
  • La Mesa, CA
  • NPI 1083056733
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912065111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3617",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919443617",
            "telephone_number": "619-460-5111",
            "fax_number": "619-460-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-460-5111",
            "fax_number": "619-460-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G12026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G120260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• BJ Budeck
• Kevin Thien Toan Bui, M.D.
• Tina Bui, O.D.
• Building Strong Roots Child and Family Therapy, Inc.
• James L. Bull
• Teresa Ann Burdick, P.T.
• Nathan Burlakovsky
• Robyn Lenore Burns, PHN
• Lauren Burton
• Charles Bush, PT, DPT

• Anesthesiology Physician in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.