Healthcare Provider Details

I. General information

NPI: 1285714378
Provider Name (Legal Business Name): FLOYD L CULLER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3814 AUBURN BLVD SUITE 72
SACRAMENTO CA
95821-2123
US

IV. Provider business mailing address

3814 AUBURN BLVD SUITE 72
SACRAMENTO CA
95821-2123
US

V. Phone/Fax

Practice location:
  • Phone: 916-426-1902
  • Fax: 916-426-1940
Mailing address:
  • Phone: 916-426-1902
  • Fax: 916-426-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number000000C39542
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: