Basic Information
| Provider Information | |||||||||
| NPI: | 1376648279 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GULLA | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 480 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939020480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316491000 | ||||||||
| FaxNumber: | 8316494966 | ||||||||
| Practice Location | |||||||||
| Address1: | 2930 2ND AVE | ||||||||
| Address2: | 200 | ||||||||
| City: | MARINA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939336244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8315822100 | ||||||||
| FaxNumber: | 8316200304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 03/11/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | RT 1383 | NH | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | A113017 | CA | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.