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NPI Code Detail

MEDICARE: DR. MATTHEW WILLIAM PULLING PSYD

MEDICARE: DR. MATTHEW WILLIAM PULLING PSYD
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1376754150
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW WILLIAM PULLING PSYD
Provider Business Mailing Address
First Line : 1127 E DEL MAR BLVD APT 131
Second Line :
City : PASADENA
State : CA
Zip : 91106-3435
Country : US
Telephone Number : 626-796-7751
Fax Number :
Provider Business Practice Location Address
First Line : 1125 W 6TH ST STE 103
Second Line :
City : LOS ANGELES
State : CA
Zip : 90017-1896
Country : US
Telephone Number : 213-241-0979
Fax Number : 213-241-0925
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 07/08/2007

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