Provider Demographics
NPI:1447331699
Name:GULINO, JOSEPH L (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:GULINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9615 BRIGHTON WAY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BEVELRY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:424-202-4477
Mailing Address - Fax:310-388-5379
Practice Address - Street 1:9615 BRIGHTON WAY
Practice Address - Street 2:SUITE 225
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5131
Practice Address - Country:US
Practice Address - Phone:424-202-4477
Practice Address - Fax:310-388-5379
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL 289362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC289360Medicaid
SCAA35293361Medicare UPIN
SC289360Medicaid