ANDREA MCCULLOUGH (NPI# 1366535890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366535890 |
| Entity Type | Individual |
| Full Name | ANDREA MCCULLOUGH |
| Credential | MD |
| Practice Address |
700 River Dr Fort Bragg CA 95437-5403 |
| Mailing Address |
2107 Livingston St Suite A Oakland CA 94606-5218 |
| Practice Telephone | 7079614655 |
| Mailing Telephone | 5104369000 |
| Mailing Fax Number | 5104369013 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-06-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
A61951 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A619510 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821235391 | Andrea Jean Mccullough | Registered Nurse | 16490 Township Road 217, Mount Victory, OH 43340-8826 | 2009-01-20 |
| 1063073831 | Andrea Boss Mccullough | Student in an Organized Health Care Education/Training Program | 1 Barnes Jew Hosp Plz, Saint Louis, MO 63110-1003 | 2019-06-24 |
| Street Address |
700 RIVER DR |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306896428 | John A Kermen | Anesthesiology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-11 |
| 1710336300 | Glass Beach Medical Services A Medical Corporation | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2016-06-06 |
| 1447585245 | Mark David Levine Md, Fort Bragg Professional Corporation | Psychiatry & Neurology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2009-10-12 |
| 1962666313 | Donald Sheffel, M.d. | Surgery | 700 River Dr, Fort Bragg, CA 95437-5403 | 2008-07-15 |
| 1891982351 | Lois Faith Leister | Pharmacist | 700 River Dr, Mendocino Coast District Hospital Pharmacy, Fort Bragg, CA 95437-5403 | 2007-09-28 |
| 1659562742 | Marilyn Magoffin | Nurse Practitioner | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-08-05 |
| 1255540340 | Phillip Conwell | Registered Nurse | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-05-22 |
| 1013060516 | Stephen Pinsk, M.d., Inc. | Clinical Medical Laboratory | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-01-19 |
| 1912079294 | Prakash P Devaskar | Pediatrics | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-11-14 |
| 1477641686 | Tamaki A. Myers | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689841876 | Pablo Oscar Medina Jr. | Emergency Medicine | 2684 Woodruff St, Fort Bragg, NC 28310-0001 | 2008-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619576576 | Thethong P Thepvong | Emergency Medicine | 900 W Belgravia Ave, Fresno, CA 93706-3909 | 2020-10-21 |
| 1003441148 | Heather K Mineo | Emergency Medicine | 1908 Spahn Ln, Placentia, CA 92870-2844 | 2020-03-10 |
| 1407497837 | Jaskaranpreet Kaur Sahota | Emergency Medicine | 426 4th Street, Marysville, CA 95901 | 2019-10-07 |
| 1215493515 | Karla Beatriz Sonnier | Emergency Medicine | 17822 Cardiff Cir, Huntington Beach, CA 92649-4807 | 2019-02-12 |
| 1568992923 | American Specialty Physicians Group Inc | Emergency Medicine | 700 17th St Ste 205, Modesto, CA 95354-1249 | 2017-06-18 |
| 1841659067 | George Michael Savage | Emergency Medicine | 2600 Bridge Parkway, Proteus Digital Health, Redwood City, CA 94065 | 2016-02-16 |
| 1053779553 | Robert Alan Hochman | Emergency Medicine | 526 Firecrest Court, Newbury Park, CA 91320-5022 | 2016-01-29 |
| 1578954319 | Amerco Health Enterprise, Inc | Emergency Medicine | 1006 E Bastanchury Rd, Fullerton, CA 92835-2782 | 2015-02-16 |
| 1134543945 | Francine Vogler | Emergency Medicine | 22631 Pacific Coast Highway, #796, Malibu, CA 90265 | 2014-02-13 |
| 1396081659 | Kent Benedict | Emergency Medicine | 3283 Valencia Ave, Aptos, CA 95003-4122 | 2012-12-13 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
Please comment or provide details below to improve the information on ANDREA MCCULLOUGH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.