Individual
DR. DAVID G FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10468 SAINT ANDREWS CT, OAKDALE, CA 95361-7602
(209) 630-1531
Mailing address
10468 SAINT ANDREWS CT, OAKDALE, CA 95361-7602
(209) 630-1531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G69104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G691040
—
CA
Enumeration date
07/03/2006
Last updated
01/03/2022
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