Organization
EDWIN B FULLER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN B. FULLER MD (DOCTOR)
(619) 267-3020
Entity
Organization
Contact information
Practice address
655 EUCLID AVE, SUITE 301, NATIONAL CITY, CA 91950-2957
(619) 267-3020
(619) 267-4042
Mailing address
655 EUCLID AVE, SUITE 301, NATIONAL CITY, CA 91950-2957
(619) 267-3020
(619) 267-4042
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C26937
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C26937
MEDICAL LICENSE
CA
Enumeration date
12/19/2006
Last updated
03/05/2009
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