Individual
KEVIN M FUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
326 SANTA FE DR STE 100, ENCINITAS, CA 92024-5157
(760) 230-8994
(760) 944-1309
Mailing address
326 SANTA FE DR STE 100, ENCINITAS, CA 92024-5157
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101269338
VA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
067298
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
C172323
CA
207RP1001X
Pulmonary Disease Physician
Primary
0101269338
VA
207RP1001X
Pulmonary Disease Physician
C172323
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003121258A
—
GA
05
—
003121258D
—
GA
Enumeration date
11/17/2005
Last updated
07/24/2025
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