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

Tyler Sullivan

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1912581356

Tyler Sullivan is an Emergency Medicine in Fresno, California. Qualified in 2021, 5 years ago. Practices with Cep America - California, a 1,267-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1313 E Herndon Ave Ste 105
Fresno, CA 93720-3306
Phone: (559) 450-5379
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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 20721 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1912581356
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 11, 2021
Last updated in NPPESJune 14, 2024
Certification dateJune 14, 2024
Mailing address1313 E Herndon Ave Ste 105, Fresno, CA 93720-3306

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Cep America - California — 1267 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fresno