Organization
CLARK BEEMAN FULLER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK B FULLER MD (PRESIDENT)
(310) 854-0909
Entity
Organization
Contact information
Practice address
8631 W 3RD ST, SUITE 1140E, LOS ANGELES, CA 90048-5901
(310) 854-0909
(310) 494-0511
Mailing address
9663 SANTA MONICA BLVD, SUITE 383, BEVERLY HILLS, CA 90210-4303
(310) 854-0909
(310) 494-0511
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
05/26/2013
Last updated
05/26/2013
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