Provider Demographics
NPI:1043240872
Name:PULL, ROBERT A (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:PULL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 POMEROY RD
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-5651
Mailing Address - Country:US
Mailing Address - Phone:805-474-4224
Mailing Address - Fax:805-474-4112
Practice Address - Street 1:1745 POMEROY RD
Practice Address - Street 2:
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-5651
Practice Address - Country:US
Practice Address - Phone:805-474-4224
Practice Address - Fax:805-474-4112
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU31448Medicare UPIN
CADC21475Medicare ID - Type Unspecified