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EDGAR MARK BULLOCH MD
NPI 1508046376
Obstetrics & Gynecology in El Cajon, CA

Active since November 09, 2007PECOS EnrolledAccepts Medicare Assignment
133 W MAIN ST STE 100, EL CAJON, CA 92020(619) 401-0404 Get Directions Write a Review

NPPES record last updated: May 26, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Edgar Mark Bulloch Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGAR MARK BULLOCH MD (NPI 1508046376) is an individual obstetrics & gynecology provider in El Cajon, California, licensed in California (A113241) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1508046376
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameEDGAR MARK BULLOCHCredential: MD
Location Address133 W MAIN ST STE 100El Cajon, CA 92020-3325
Mailing Address823 Gateway Center WaySan Diego, CA 92102-4541 · (619) 515-2323 · Fax (619) 906-4564
Phone(619) 401-0404
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateNovember 9, 2007
Last NPPES UpdateMay 26, 2021
NPPES CertifiedMay 26, 2021
✔ NPI 1508046376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in CA · A113241
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedSpecialistTaxonomy 174400000X · License BP10025759 (TX)
133 W MAIN ST STE 100, El Cajon, CA 92020
Open in Google Maps ↗

Secondary Practice Location 1

Location 11809 National Avenue, Logan Heights Family Health CenterSan Diego, CA 92113 · Phone (619) 515-2300 · Fax (619) 234-2447

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edgar Mark Bulloch Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941494264
PECOS Enrollment IDI20101101000717
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92020 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GEORGE MANUEL ZAMBRANA P.A
Physician Assistant
133 W MAIN ST STE 100
EL CAJON, CA 92020
San Diego County (619) 401-0404
JOSE MARTIN NUNO P.A.
Physician Assistant
133 W MAIN ST STE 100
EL CAJON, CA 92020
San Diego County (619) 401-0404
TAMARA J. TUCKER-HAM N.P.
Nurse Practitioner (Family)
133 W MAIN ST STE 100
EL CAJON, CA 92020
San Diego County (619) 401-0404
ALANA RETA GHANIM MD
Pediatrics
133 W MAIN ST STE 100
EL CAJON, CA 92020
San Diego County (619) 401-0404
MR. WILLIAM DAVID HOLDER PHYSICIAN ASSISTANT
Physician Assistant
133 W MAIN ST STE 100
EL CAJON, CA 92020
San Diego County (619) 401-0404
MARICEL VELUZ DELACRUZ
Nurse Practitioner (Family)
133 W MAIN ST STE 100
EL CAJON, CA 92020
San Diego County (619) 401-0404
GIZZELE VICTORIA VALENCIA-DELGADO DNP, FNP-C
Nurse Practitioner
133 W MAIN ST STE 100
EL CAJON, CA 92020
San Diego County (619) 401-0404

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgar Bulloch's NPI number?

The NPI number for Edgar Bulloch is 1508046376. It was assigned to this individual provider in the NPPES registry on November 9, 2007.

Where is Edgar Bulloch located?

Edgar Bulloch practices at 133 W Main St Ste 100, El Cajon, CA 92020. The listed phone number is (619) 401-0404.

What is Edgar Bulloch's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Edgar Bulloch enrolled in Medicare?

Yes. Edgar Bulloch is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Edgar Bulloch was last updated on May 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.