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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