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Contact Information

FERNANDO ULLOA, MD
711 D ST
SUITE 113
SAN RAFAEL, CA94901-3707
 Phone: 415-454-4100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for FERNANDO ULLOA · (Male)

NPI # 1124140686
Status Active
Credentials MD
Entity Individual
Enumeration date 04/04/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # G49903
  • CA Medicaid 00G49903
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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