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Physician Compare National (NPI:1912034158)

HEALTHCARE PROVIDER:

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1912034158
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0345224572
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20141220000432
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name TULKIN
Individual professional last name
Provider First Name STEVEN
Individual professional first name
Provider Middle Name ROBERT
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text CP
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1971
Individual professional's medical school graduation year
Primary Specialty PSYCHOLOGIST, CLINICAL
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 1650 BOREL PL
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 223
Group Practice or individual's line 2 address
City SAN MATEO
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 944023508
Group Practice or individual's zip code (9 digits when available)
Phone Number 6505793578
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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