Provider Demographics
NPI:1952341125
Name:PULLEY, DOUGLAS B (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:B
Last Name:PULLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10300 S DE ANZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3030
Mailing Address - Country:US
Mailing Address - Phone:408-252-7100
Mailing Address - Fax:408-257-8355
Practice Address - Street 1:393 BLOSSOM HILL RD
Practice Address - Street 2:SUITE 265
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1652
Practice Address - Country:US
Practice Address - Phone:408-227-7122
Practice Address - Fax:408-227-7722
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA24242207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A242420Medicaid
CA00A242420Medicare ID - Type Unspecified
CA00A242420Medicaid