Individual provider Active NPI

Gregory T Pulas, DPM

  • Podiatrist
  • Stockton, CA
National Provider Identifier
1972599355
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2807 Issued in CA
Practice address
3031 W March LN
203
Stockton, CA 95219-6500
Phone
(209) 956-2847
Fax
(209) 956-3514
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E2807 CA Primary

Addresses

Primary practice location

3031 W March LN
203
Stockton, CA 95219-6500

Mailing address

3031 W March LN
203W
Stockton, CA 95219-6500
Phone (209) 956-2847

Other identifiers 2

IdentifierTypeStateIssuer
000E28070MedicaidCA
000E28071MedicaidCA

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

State licenses

LicenseStateTypeSpecialty
E2807CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1972599355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W MARCH LN",
            "address_2": "203W",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196500",
            "telephone_number": "209-956-2847",
            "fax_number": "209-956-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W MARCH LN",
            "address_2": "203",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196500",
            "telephone_number": "209-956-2847",
            "fax_number": "209-956-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULAS",
        "first_name": "GREGORY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E28070",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E28071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.