Provider Demographics
NPI:1467423483
Name:BULL, DALE HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:HAROLD
Last Name:BULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 WESTBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5348
Mailing Address - Country:US
Mailing Address - Phone:858-442-7600
Mailing Address - Fax:858-729-0590
Practice Address - Street 1:421 WESTBOURNE ST
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-5348
Practice Address - Country:US
Practice Address - Phone:858-442-7600
Practice Address - Fax:858-729-0590
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0631552080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine