MEDICARE: PREETHY MATHEW KULAKAT NP

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
1	363LA2100X	Acute Care Nurse Practitioner	95038845	CA

General Provider Information

NPI Number	:	1154277846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PREETHY MATHEW KULAKAT NP

Provider Business Mailing Address
First Line	:	2167 W CHERRYWOOD LN
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-2492
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2167 W CHERRYWOOD LN
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-2492
Country	:	US
Telephone Number	:	323-743-6794
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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