Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Brian Sullivan, DO

Individual provider Military Health Care Provider · NPI 1194245662

Kevin Brian Sullivan, DO is an Emergency Medicine in San Diego, California. Qualified in 2017, 9 years ago. Practices with Cep America - California, a 1,267-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2017
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone: (970) 640-5914
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 20A18937 (CA)
Military Health Care Provider Taxonomy 171000000X · Licence 1194245662 (CA)

Record details

NPI number1194245662
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedJune 26, 2017
Last updated in NPPESAugust 6, 2021
Certification dateAugust 6, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Cep America - California — 1267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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