Organization
KARLIS ULLIS, M.D., A PROFESSIONAL CORPORATION
Active
Other names
Sports Medicine & Preventive Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARLIS CONRAD ULLIS M.D. (MEDICAL DIRECTOR)
(310) 452-1990
Entity
Organization
Contact information
Practice address
900 WILSHIRE BLVD, SUITE 425, SANTA MONICA, CA 90401-1872
(310) 452-1990
(310) 452-5134
Mailing address
900 WILSHIRE BLVD, SUITE 425, SANTA MONICA, CA 90401-1872
(310) 452-1990
(310) 452-5134
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
G20989
CA
2083S0010X
Sports Medicine (Preventive Medicine) Physician
G20989
CA
Other
Enumeration date
04/02/2009
Last updated
03/07/2014
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