Individual
DR. COREY BRANDON FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25455 BARTON RD STE 102B, LOMA LINDA, CA 92354-3139
(909) 558-6444
(909) 558-6118
Mailing address
11406 LOMA LINDA DR STE 226, LOMA LINDA, CA 92354-3711
(909) 558-6644
(909) 558-6118
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A118405
CA
207X00000X
Orthopaedic Surgery Physician
MD229227
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A118405
CA
Other
Enumeration date
04/07/2010
Last updated
03/18/2026
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