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Individual

DR. ERIC ARTHUR FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1178 SAN PABLO AVE, SUITE A, BERKELEY, CA 94706-2245
(510) 526-1335
(510) 526-4419
Mailing address
1111 ORDWAY ST, ALBANY, CA 94706-2515
(510) 527-1119
(510) 524-9406

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3543
CA
213ES0000X
Sports Medicine Podiatrist
E3543
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BBB80382B
EDI SUBMITTER NUMBER
CA
Enumeration date
09/02/2005
Last updated
12/17/2009
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