DR. PETER FEDULLO (NPI# 1427073683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427073683 |
| Entity Type | Individual |
| Full Name | DR. PETER FEDULLO |
| Credential | M.D. |
| Practice Address |
200 W Arbor Dr San Diego CA 92103-9000 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 6195437752 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2019-01-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
G41977 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
G41977 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G419770 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275833931 | Peter Anthony Fedullo | Physician Assistant | 622 W 168th St, New York, NY 10032-3720 | 2010-10-28 |
| Street Address |
200 W ARBOR DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215502 | Alfredo B. Tiu | Internal Medicine | 200 W Arbor Dr, Owen Clinic, San Diego, CA 92103-9001 | 2005-06-20 |
| 1841806536 | Kevin Thai Nguyen | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-18 |
| 1003421256 | Jessica Lynette Montoya | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-14 |
| 1013522838 | Julianna L Gorder | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-09 |
| 1992318828 | Yodit Mekonnen Teklu | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1356954283 | Dalia Siada | Dietitian, Registered | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1699383588 | Rachael Ashley Gordon | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-17 |
| 1124646906 | Jeffrey David Bernstein | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr, Mc 1234, San Diego, CA 92103-9000 | 2020-07-08 |
| 1639796071 | Darcie D Brown | Marriage & Family Therapist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-01 |
| 1194340919 | Han B Dinh | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093198392 | Abdurrahman Akhlaq Husain | Internal Medicine | 8555 Aero Dr Ste 104, San Diego, CA 92123-1744 | 2015-07-04 |
| 1639447337 | Richard David Kremsdorf | Internal Medicine | 4172 Combe Way, San Diego, CA 92122-2511 | 2011-12-08 |
| 1962738641 | Xavier Soler | Internal Medicine | 200 West Arbor Dr - 8201, Ucsd Medical Center, San Diego, CA 92103-8201 | 2009-10-30 |
| 1437327053 | Jan Rodger Radke | Internal Medicine | 13241 Luckett Ct, San Diego, CA 92130-3225 | 2008-02-16 |
| 1124079793 | Samuel J. Clark, M.d., Inc. | Internal Medicine | 1940 El Cajon Blvd, San Diego, CA 92104-1005 | 2006-05-16 |
| 1134190945 | Kenneth Lee Eisenberg | Internal Medicine | 3480 Bob Wilson Drive, Nmcsd,att Medical Staff Services, San Diego, CA 92134 | 2006-01-30 |
| 1023006418 | Gregg Garner | Internal Medicine | 1684 Torrance St, San Diego, CA 92103-3746 | 2005-10-10 |
| 1922008598 | Gang Bao | Internal Medicine | 6699 Alvarado Rd Ste 2306, San Diego, CA 92120-5241 | 2005-07-26 |
| 1891280228 | Gregory P. Ranches Md, Apc | Internal Medicine | 501 Washington St., Ste 508, San Diego, CA 92103 | 2018-06-27 |
| 1891207171 | Iha Pulmonary Inc | Internal Medicine | 7801 Mission Center Ct, San Diego, CA 92108-1313 | 2017-10-26 |
| 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.