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General NPI Number Information
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NPI Number | 1871085514
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Entity Type | Organization
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Legal Business Name | D.K. BULLARD INC.
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 9057 SOQUEL DR. BLDG. A, SUITE D
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City | APTOS
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State | CA
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Zip | 95003
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Country | US
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Telephone | 831-662-0400
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Fax | 831-662-0402
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Provider Business Mailing Address
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Address Line | 9057 SOQUEL DR. BLDG. A, SUITE D
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City | APTOS
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State | CA
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Zip | 95003
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Country | US
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Telephone | 831-662-0400
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Fax | 831-662-0402
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID BULLARD
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Credential |
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Telephone | 831-662-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 444700005
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 444700005
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License Number State | CA
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