Healthcare Provider Details

I. General information

NPI: 1962542183
Provider Name (Legal Business Name): EILEEN BULGER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 MARKET ST
SAN FRANCISCO CA
94102-6228
US

IV. Provider business mailing address

1930 MARKET ST
SAN FRANCISCO CA
94102-6228
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-7578
  • Fax: 415-502-7240
Mailing address:
  • Phone: 415-502-7578
  • Fax: 415-502-7240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number444324
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: