# EDWIN B FULLER MD INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164586905
- **Authorized official:** EDWIN B. FULLER MD (DOCTOR)
- **Authorized official phone:** (619) 267-3020

## Contact information

- **Practice address:** 655 EUCLID AVE, SUITE 301, NATIONAL CITY, CA 91950-2957
- **Practice address phone:** (619) 267-3020
- **Practice address fax:** (619) 267-4042
- **Mailing address:** 655 EUCLID AVE, SUITE 301, NATIONAL CITY, CA 91950-2957
- **Mailing address phone:** (619) 267-3020
- **Mailing address fax:** (619) 267-4042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | C26937 | CA | Yes |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 03/05/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | C26937 | MEDICAL LICENSE | CA |