DREW SULLIVAN (NPI# 1992716997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992716997 |
| Entity Type | Individual |
| Full Name | DREW SULLIVAN |
| Credential | MD |
| Practice Address |
625 Lincoln Ave San Jose CA 95126-3705 |
| Mailing Address |
400 Race St San Jose CA 95126-3518 |
| Practice Telephone | 4082783310 |
| Practice Fax Number | 4082783378 |
| Mailing Telephone | 4082783000 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2008-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G32274 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G322740 | 05 |
| Street Address |
625 LINCOLN AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95126-3705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700850708 | Brian Farris | Internal Medicine | 625 Lincoln Ave, San Jose, CA 95126-3705 | 2006-02-15 |
| 1447817309 | Liane Christine Tongol | Physician Assistant | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2019-05-24 |
| 1689014755 | Sheetal Ankolekar | Family Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2013-07-03 |
| 1902145592 | Thanh-tam Ngoc Nguyen | Family Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2013-02-03 |
| 1023360930 | Daniel Hudson Morgan | Family Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2012-10-03 |
| 1326312067 | Verity Medical Foundation | Clinic/Center | 625 Lincoln Ave, San Jose, CA 95126-3705 | 2012-02-27 |
| 1053604652 | Hd Ultrasound, LLC | Clinic/Center | 625 Lincoln Ave, Suite 201, San Jose, CA 95126-3705 | 2011-05-16 |
| 1437469129 | Steven How-han Sheh | Internal Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2010-10-14 |
| 1568503654 | Physicians Medical Group of San Jose, Inc. | Non-Pharmacy Dispensing Site | 625 Lincoln Ave, San Jose, CA 95126-3705 | 2007-02-09 |
| 1871658864 | Ruta V Wakharkar | Internal Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2006-12-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356830418 | Esperanza Maravilla | Counselor | 1259 Park Ave, Apt 15, San Jose, CA 95126 | 2018-05-04 |
| 1811417819 | Sahr Lawande | Occupational Therapist | 1373 University Ave, San Jose, CA 95126 | 2017-06-21 |
| 1063941482 | Yang Li | Acupuncturist | 1520 Southwest Expy Unit 141, San Jose, CA 95126 | 2017-06-08 |
| 1598294860 | Camille Campbell | Counselor | 1400 Parkmoor Avenue, Suite 115, San Jose, CA 95126 | 2017-06-08 |
| 1588193387 | Vanessa Aspera | Case Manager/Care Coordinator | 1400 Parkmoor Avenue, San Jose, CA 95126 | 2017-06-06 |
| 1538692603 | Alexa Stine Fields | Acupuncturist | 714 Harding Ave, San Jose, CA 95126 | 2017-04-06 |
| 1669903647 | Lillette Rosete | Assisted Living Facility | 960 Vermont St, San Jose, CA 95126 | 2017-03-22 |
| 1952847105 | Dana Ninkham | Behavior Technician | 1922 The Alameda Suite 425, San Jose, CA 95126 | 2017-01-12 |
| 1811441199 | Cristina Morales Delgado | Community Health Worker | 1400 Parkmore Avenue, Suite 115, San Jose, CA 95126 | 2016-08-04 |
| 1053770123 | Felicia Nibungco | Marriage & Family Therapist | 1922 The Alameda Ste 326, San Jose, CA 95126 | 2016-02-18 |
| Find all providers in zip 95126 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1174814214 | Bhargav Raman | Radiology | 2039 Forest Ave Ste 205, San Jose, CA 95128-4817 | 2011-04-25 |
| 1649596792 | Omnirad Medical Group, Inc. | Radiology | 2410 Samaritan Dr Ste 101, San Jose, CA 95124-3909 | 2010-04-14 |
| 1275775207 | Priyanka Jha | Radiology | 750 Cedarville Ln, San Jose, CA 95133-2076 | 2009-04-06 |
| 1346345360 | John Randolph Jinkins | Radiology | 828 S Bascom Ave Ste 110, San Jose, CA 95128-2652 | 2006-09-14 |
| 1356352660 | Radiological Associates Medical Group, Inc | Radiology | 2410 Samaritan Drive, Suite 102, San Jose, CA 95124-3909 | 2006-08-11 |
| 1780621763 | California Advanced Imaging Medical Assoc., Inc. | Radiology | 550 S Winchester Blvd Ste 110, San Jose, CA 95128-2526 | 2006-05-31 |
| 1558322180 | Michael Glenn Myers | Radiology | 6496 Deer Hollow Dr, San Jose, CA 95120-1634 | 2006-03-31 |
| 1568453421 | Rory Satterfield | Radiology | 798 S Winchester Blvd, San Jose, CA 95128-2928 | 2005-10-31 |
| 1528054582 | Glenn Strome | Radiology | 3031 Tisch Way Ste 400, San Jose, CA 95128-2531 | 2005-09-26 |
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| 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.