# ARCH STREET MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Arch Street Medical Associates, Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396041208
- **Authorized official:** DR. PETER J BULLUCK MD (CEO)
- **Authorized official phone:** (650) 366-1141

## Contact information

- **Practice address:** 143 BIRCH STREET, REDWOOD CITY, CA 94062
- **Practice address phone:** (650) 366-1141
- **Practice address fax:** (650) 366-1265
- **Mailing address:** 143 BIRCH STREET, REDWOOD CITY, CA 94062
- **Mailing address phone:** (650) 366-1141
- **Mailing address fax:** (650) 366-1265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A31093 | CA | Yes |

## Other

- **Enumeration date:** 02/10/2011
- **Last updated:** 02/11/2011