Provider Demographics
NPI:1689828378
Name:BULKIN, ANN GARDIN (MPT)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:GARDIN
Last Name:BULKIN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4126
Mailing Address - Country:US
Mailing Address - Phone:415-702-9206
Mailing Address - Fax:415-341-0380
Practice Address - Street 1:3354 20TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2784
Practice Address - Country:US
Practice Address - Phone:415-702-9206
Practice Address - Fax:415-341-0380
Is Sole Proprietor?:No
Enumeration Date:2008-11-09
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist