DR. TIMOTHY C BULLARD MD NPI 1306801766

NPI Information

  • NPI: 1306801766
  • Provider Name: DR. TIMOTHY C BULLARD, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4560 ADMIRALTY WAY STE 100
    MARINA DEL REY, CA
    ZIP 90292
  • Phone: (108) 273-7003

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NPI Details

DR. Timothy C Bullard, MD is a family medicine in Marina Del Rey, CA with 31 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Timothy C Bullard, MD NPI is 1306801766. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1995

The provider's business location address is:

4560 ADMIRALTY WAY STE 100
MARINA DEL REY, CA
ZIP 90292-424
Phone: (108) 273-7003

The NPI 1306801766 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • Urinalysis, manual test (HCPCS:81002)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only (HCPCS:93010)
  • Emergency department visit for life threatening or functioning severity (HCPCS:99285)

The enumeration date for this NPI number is 4/19/2006 and was last updated on 10/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency MedicineA64738CALIFORNIANo
2207P00000XEmergency Medicine01051619INDIANANo
3207P00000XEmergency Medicine4301082809MICHIGANNo
4207Q00000XFamily MedicineA64738CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1930098046OTHERCALIFORNIARAILROAD
21306801766MEDICAIDMICHIGAN
31306801766OTHERMICHIGANBC BS MI
400A647380MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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