NPIMap

Organization Active NPI

Putt C Petrulli DPM

  • Podiatrist
  • Alhambra, CA
National Provider Identifier
1922120971
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2492 Issued in CA
Legal business name
PUTT C PETRULLI DPM
Practice address
330 N Garfield Ave
Ste 6
Alhambra, CA 91801-2400
Phone
(626) 282-9950
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Putt C Petrulli, DPMNPI 1871517102
Title
Owner
Phone
(626) 282-9950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X E2492 CA Primary

Addresses

Primary practice location

330 N Garfield Ave
Ste 6
Alhambra, CA 91801-2400

Mailing address

330 N Garfield Ave
Ste 6
Alhambra, CA 91801-2400
Phone (626) 282-9950

Other identifiers 1

IdentifierTypeStateIssuer
000E24920MedicaidCA

Other names 1

  • Alhambra Podiatry Group Former legal business name

National Provider Directory

National Provider Directory

Locations

330 N Garfield Ave
Ste 6
Alhambra, CA 91801
Phone (626) 282-9950

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1922120971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N GARFIELD AVE",
            "address_2": "STE 6",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918012400",
            "telephone_number": "626-282-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N GARFIELD AVE",
            "address_2": "STE 6",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918012400",
            "telephone_number": "626-282-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTT C PETRULLI DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "PETRULLI",
        "authorized_official_first_name": "PUTT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-282-9950",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E24920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alhambra Podiatry Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Alhambra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.