Organization
DAVID G FULLER MD A PROFESSIONAL CORPORATION
Active
Other names
David G Fuller MD A Prof Corp
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GLENN FULLER MD (CEO)
(209) 605-4497
Entity
Organization
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
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/25/2021
Last updated
11/25/2021
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