MEDICARE: DR. JO ANN PULLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	G54941	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225005663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JO ANN PULLEN MD

Provider Business Mailing Address
First Line	:	1711 W TEMPLE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-5421
Country	:	US
Telephone Number	:	213-207-5000
Fax Number	:	213-273-8391

Provider Business Practice Location Address
First Line	:	1711 W TEMPLE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-5421
Country	:	US
Telephone Number	:	213-207-5000
Fax Number	:	213-273-8391

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	03/07/2023

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