Individual
DR. LAURA SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7316 S. SETTLER DR., MORRISON, CO 80465
(714) 722-4688
(562) 904-8095
Mailing address
7316 S. SETTLER DR., MORRISON, CO 80465
(714) 722-4688
(562) 920-4642
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G55298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G552980
BLUE SHIELD
CA
05
—
00G552980
—
CA
05
—
00G952980
—
CA
01
—
110227243
MEDICARE RAILROAD
CA
Enumeration date
08/01/2006
Last updated
11/26/2019
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