Provider Demographics
NPI:1437880507
Name:BULLO LLC
Entity Type:Organization
Organization Name:BULLO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HIZKEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GENET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-408-8033
Mailing Address - Street 1:4813 RIDGE RD # 1111102
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-6117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6533 BELLHURST LN
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-1653
Practice Address - Country:US
Practice Address - Phone:510-408-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)