KEVIN BRIAN SULLIVAN (NPI# 1194245662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194245662 |
| Entity Type | Individual |
| Full Name | KEVIN BRIAN SULLIVAN |
| Credential | DO |
| Practice Address |
34800 Bob Wilson Dr San Diego CA 92134-1098 |
| Practice Telephone | 9706405914 |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2017-06-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | 1194245662 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356886998 | Kevin Doerr Sullivan | Physician Assistant | 208 Cedar Creek Ter, Ione, WA 99139-5011 | 2017-01-05 |
| 1750734992 | Kevin Sullivan | Specialist/Technologist | 936 Wynn Rd, Mcdonough, GA 30252-5802 | 2016-07-22 |
| 1457508996 | Kevin A. Sullivan | Counselor | 1500 W. Main St. Ste 300, Phoenix Counseling, Sun Prairie, WI 53590 | 2008-08-27 |
| 1770638066 | Kevin Patrick Sullivan | Dentist | 305 E 2nd Ave, Ellensburg, WA 98926-3315 | 2007-01-24 |
| 1447276225 | Kevin L. Sullivan | Radiology | 250 Ponce De Leon Ave, Suite 100, Decatur, GA 30030-3406 | 2006-07-14 |
| 1750940615 | Kevin Thomas Sullivan | Dentist | 1475 Pine Grove Rd Ste 107, Steamboat Springs, CO 80487-8851 | 2019-06-13 |
| 1275196172 | Kevin Sullivan | Behavior Technician | 1301 E Orangewood Ave, Anaheim, CA 92805-6807 | 2019-04-16 |
| 1467806125 | Kevin Sullivan | Hospitalist | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2016-04-19 |
| 1023479839 | Kevin Sullivan | Occupational Therapist | 5006 Copper Ave Ne, Albuquerque, NM 87108-1301 | 2016-03-08 |
| 1023478971 | Kevin Sullivan | Occupational Therapist | 7540 N 19th Ave Ste 200, Phoenix, AZ 85021-7967 | 2016-03-03 |
| Street Address |
34800 BOB WILSON DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92134-1098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245235134 | Willie S Chao | Dentist | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2005-06-16 |
| 1023625571 | Samantha Savite | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-09-29 |
| 1588270326 | Angelina Yvette Harris | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-09-17 |
| 1275149296 | Alexa Werner | Physical Therapist | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-09-16 |
| 1376157164 | Toure Marlow Hinton | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-31 |
| 1316550106 | John K Housinga | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-31 |
| 1073126249 | Alfredo Carrillo | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-27 |
| 1326651647 | Daniel Adan Denge | Registered Nurse | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-26 |
| 1275146664 | Zachariah Jacob Charles Boydsnee | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-26 |
| 1245843820 | Nikole Lanchares | Dentist | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178457 | Joseph Hunter Sampson | Military Health Care Provider | 34101 Farenholt Ave #14, San Diego, CA 92134 | 2020-06-15 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1255870333 | Dosh Page | Physician Assistant | Swmi Farenholt Avenue, Building 14, San Diego, CA 92134 | 2017-02-22 |
| 1417328063 | Noem Clay Gallego | Military Health Care Provider | 34101 Building 14, Farenholt Avenue, San Diego, CA 92134 | 2015-10-08 |
| 1972999183 | Justin Paul Lachney | Military Health Care Provider | 34101 Farenholt Avenue, San Diego, CA 92134 | 2015-04-14 |
| 1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
| 1447591268 | Amy B. Cornell | Student in an Organized Health Care Education/Training Program | 34800 Bob Wilson Drive, San Diego, Ca, Apo, AA 92134 | 2013-03-04 |
| 1841562956 | Christopher Patrick Androski Jr. | Emergency Medical Technician, Basic | Naval Medical Center San Diego 38400 Bob Wilson Dr, San Diego, CA 92134 | 2012-02-04 |
| 1164717740 | Jason James Weiner | Internal Medicine | Dept of Internal Medicine, Division of Rheumatology, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2011-06-13 |
| 1225320237 | Kimberly Ann Thompson | Student in an Organized Health Care Education/Training Program | Navy Medical Center San Diego Gme Department, 34800 Bob Wilson Dr., San Diego, CA 92134 | 2011-05-09 |
| Find all providers in zip 92134 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692389 | Christopher Matey | Military Health Care Provider | 34800 Bob Wilson Dr Ste 110, San Diego, CA 92134-1110 | 2020-05-29 |
| 1982225769 | Jin Ah Kim | Military Health Care Provider | Naval Medical Center San Diego 38400 Bon Wilson Drive, San Diego, CA 92134-5000 | 2020-05-03 |
| 1508495201 | Benjamin Michael Taylor | Military Health Care Provider | Naval Medical Center San Diego Psychiatry Residency Pgm, 34800 Bob Wilson Drive, San Diego, CA 92134 | 2020-04-04 |
| 1588292858 | Korina Erin Sandoval | Military Health Care Provider | Naval Medical Center Drive 38400 Bob Wilson Dr, San Diego, CA 92134-5000 | 2020-03-31 |
| 1033746508 | Hannah Johnson | Military Health Care Provider | 34800 Bob Wilson Dr Ste 403, San Diego, CA 92134-1403 | 2020-03-25 |
| 1891336541 | Prana Hands Nonprofit | Military Health Care Provider | 2180 Garnet Ave Ste 3l, San Diego, CA 92109-3676 | 2019-10-03 |
| 1992366587 | Darion Pegues | Military Health Care Provider | 3530 Kelsey St, San Diego, CA 92124-3516 | 2019-06-24 |
| 1083275762 | Tyler Bradshaw Thompson | Military Health Care Provider | 34, Farenholt Ave, San Diego, CA 92134-0001 | 2019-06-24 |
| 1558924274 | Nathan Alley-byrd | Military Health Care Provider | Navy Medical Center San Diego 34800 Bob Wilson Drive, San Diego, CA 92134-0001 | 2019-04-18 |
| 1013570290 | Mckennan A Cook | Military Health Care Provider | Nmcsd 34800 Bob Wilson Drive, San Diego, CA 92134-3300 | 2019-04-15 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.