Organization
CHARLES L. FULBECK, M.D., INC
Active
Organization
CHARLES L. FULBECK, M.D., INC
Active
Other names
Charles L. Fulbeck, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L. FULBECK MD (PHYSICIAN)
(805) 549-9533
Entity
Organization
Contact information
Practice address
1551 BISHOP ST, SUITE 420, SAN LUIS OBISPO, CA 93401-4635
(805) 549-9533
(805) 549-8001
Mailing address
PO BOX 25665, SALT LAKE CITY, UT 84125-0665
(805) 549-9533
(805) 549-8001
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G50143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G501430
—
CA
Enumeration date
10/19/2006
Last updated
08/22/2020
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