Individual
RICHARD TULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-8311
Mailing address
PO BOX 30959, LOS ANGELES, CA 90030-0959
(909) 558-3014
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G23737
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G237370
—
CA
Enumeration date
07/14/2006
Last updated
07/08/2007
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