| Doctor Name: | DR. JOHN CHARLES SULLIVAN |
| NPI Number: | 1497043079 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C16944 |
| Business Practice Address: | 16226 Whittier Blvd Whittier, CA - 906032901 |
| Business Phone Number: | 5629029994 |
| Business Fax Number: | 5629029389 |
| Mailing Address: | 16226 Whittier Blvd, WHITTIER |
| State: | CA |
| Postal Code: | 906032901 |
| Phone Number: | 5629029994 |
| Fax Number: | 5629029389 |
| NPI Enumeration Date: | 07/15/2011 |
| NPI Last Update Date: | 07/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C16944 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |