Individual
NICHOLAS S FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 S SPALDING DR, SUITE 301, BEVERLY HILLS, CA 90212-1800
(310) 385-7755
Mailing address
1590 ROSECRANS AVE, STE D357, MANHATTAN BEACH, CA 90266-3727
(310) 883-3388
(951) 461-7074
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G83197
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G83197
CA
Other
Enumeration date
03/29/2006
Last updated
07/26/2019
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