MEDICARE: DR. CAREY ANN CULLINANE M.D.

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	208600000X	Surgery Physician	A71149	CA

General Provider Information

NPI Number	:	1801846548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAREY ANN CULLINANE M.D.

Provider Business Mailing Address
First Line	:	637 19TH ST
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-2508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11800 WILSHIRE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6602
Country	:	US
Telephone Number	:	310-231-2121
Fax Number	:

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	01/26/2026

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