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Individual

DR. PETER P RULLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
256 LANDIS AVE, 3RD FLOOR, CHULA VISTA, CA 91910-2650
(619) 426-9600
(619) 426-4112
Mailing address
256 LANDIS AVE, 3RD FLOOR, CHULA VISTA, CA 91910-2650
(619) 426-9600
(619) 426-4112

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
G42243
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G42243
CA
207NS0135X
Procedural Dermatology Physician
Primary
G42243
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZZ73699Z
CA
Enumeration date
06/20/2006
Last updated
03/07/2013
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