Healthcare Provider Details

I. General information

NPI: 1396109310
Provider Name (Legal Business Name): ESME CULLEN MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W. MACARTHUR BLVD KAISER PERMANENTE OAKLAND MEDICAL CENTER
OAKLAND CA
94611
US

IV. Provider business mailing address

275 W. MACARTHUR BLVD KAISER PERMANENTE OAKLAND MEDICAL CENTER
OAKLAND CA
94611
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA154469
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: