Individual provider · Type 1 NPI
Fernando Ulloa, MD
Pediatric Adolescent Medicine Physician · San Rafael, CA
NPI number
1124140686
Active
Practice location
711 D St, Suite 113
San Rafael, CA 94901-3707
Mailing address
PO Box 1938
Mill Valley, CA 94942-1938
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Adolescent Medicine Physician Primary | 2080A0000X | G49903 (CA) |
Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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About NPI 1124140686
Fernando Ulloa, MD's National Provider Identifier is 1124140686, issued on Apr 4, 2007. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in San Rafael, CA. The record was last updated on Jul 8, 2007.