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Individual
JOHN SULLIVAN
Active
Individual
JOHN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
50369
CA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
50369
CA
208U00000X
Clinical Pharmacology Physician
50369
CA
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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