Search › California › 2084N0400X
Michael Sullivan, MD
NPI 1336105626 · on the registry since 2006 · sole proprietor
Practice
- Address
- 2101 South Ave
So Lake Tahoe, CA 96150 - Phone
- (530) 542-5744
- Fax
- (530) 542-5747
Registry record
- Primary taxonomy
- 2084N0400X
2084N0400X
- Also registered as
- 2084N0400X
- Licence states on file
- CA, NV
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-09-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California