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Individual

GARY M FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RNFA

Contact information

Practice address
351 HEARST AVE, SAN FRANCISCO, CA 94112-1348
(415) 272-2203
Mailing address
351 HEARST AVE, SAN FRANCISCO, CA 94112-1348
(415) 272-2203

Taxonomy

Speciality
Code
Description
License number
State
364SM0705X
Medical-Surgical Clinical Nurse Specialist
Primary
327890
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
327890
STATE LICENSE
CA
Enumeration date
01/26/2007
Last updated
02/08/2017
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