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NPI Code Detail

MEDICARE: DIANA MARIE BULL M.A.

MEDICARE: DIANA MARIE BULL M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1063614014
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA MARIE BULL M.A.
Provider Business Mailing Address
First Line : 26137 LA PAZ RD STE 230
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-5337
Country : US
Telephone Number : 619-890-7438
Fax Number :
Provider Business Practice Location Address
First Line : 26137 LA PAZ RD STE 230
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-5337
Country : US
Telephone Number : 619-890-7438
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2007
Last Update Date : 12/01/2010

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Directions to “ DIANA MARIE BULL M.A.” Practice Location

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