Provider Demographics
NPI:1720317753
Name:RULLO, ORNELLA J (MD)
Entity type:Individual
Prefix:DR
First Name:ORNELLA
Middle Name:J
Last Name:RULLO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:MDCC 12-430
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1752
Mailing Address - Country:US
Mailing Address - Phone:310-825-6481
Mailing Address - Fax:310-825-9832
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:MDCC 12-430
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1752
Practice Address - Country:US
Practice Address - Phone:310-825-6481
Practice Address - Fax:310-825-9832
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2012-11-06
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Provider Licenses
StateLicense IDTaxonomies
CAA908282080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A908280Medicaid
CA00A908280Medicaid