Ian Thomas Pulliam D.O.

NPI 1245262682 - Family Medicine - 207QS0010X

NPI Details
NPI 1245262682
Gender Male
Enumeration Date 07/07/2006
Last Updated 03/21/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
644 W 12TH ST
TRACY CA, 95376-3437, US
Phone (209) 832-8984
Fax (209) 832-8988
Business Location
644 W 12TH ST
TRACY CA, 95376-3437, US
Phone (209) 832-8984
Fax (209) 832-8988
Toxanomy
Taxonomy Code 207QS0010X
License State California
License Number 20A7496
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According to our database, Dr. Ian Thomas Pulliam D.O. NPI is 1245262682, taxonomy code is 207QS0010X and license number is 20A7496, license state is located at California. Ian Thomas Pulliam D.O. physically located at 644 W 12th St, Tracy CA, 95376-3437. NPI Number Ian Thomas Pulliam D.O. has the Individual type.

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1245262682 NPI number is provided on an as is basis without warranty of any kind. 1245262682 is maintained by the National Plan & Provider Enumeration System. The contents of Ian Thomas Pulliam D.O. are for informational purposes only.