Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 22265 | FL |
Y | 207X00000X | Orthopaedic Surgeon | A113220 | CA |
N | 207XS0106X | Orthopaedic Hand Surgeon | A113220 | CA |
NPI | 1194968834 |
---|---|
Provider Name | Dr. Alan Christopher Sull |
First Address | Santa Monica, CA 90401-2478 |
Second Address | Santa Monica, CA 90404-2139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 22/05/2019 |