Individual provider Active NPI

Douglas B Pulley, M.D.

  • Ophthalmology Physician
  • San Jose, CA
National Provider Identifier
1952341125
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A24242 Issued in CA
Practice address
393 Blossom Hill Rd
Suite 265
San Jose, CA 95123-1652
Phone
(408) 227-7122
Fax
(408) 227-7722
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A24242 CA Primary

Addresses

Primary practice location

393 Blossom Hill Rd
Suite 265
San Jose, CA 95123-1652

Mailing address

10300 S de Anza Blvd
Cupertino, CA 95014-3030
Phone (408) 252-7100

Other identifiers 1

IdentifierTypeStateIssuer
00A242420MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24242CAMDDentist
A24242CAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1952341125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 S DE ANZA BLVD",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143030",
            "telephone_number": "408-252-7100",
            "fax_number": "408-257-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 BLOSSOM HILL RD",
            "address_2": "SUITE 265",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951231652",
            "telephone_number": "408-227-7122",
            "fax_number": "408-227-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEY",
        "first_name": "DOUGLAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A24242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A242420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.