Individual
DAVID FUKUDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
721 NEVADA ST, SUITE #406, REDLANDS, CA 92373-8079
(909) 528-6858
(909) 798-9999
Mailing address
PO BOX 972, LOMA LINDA, CA 92354-0972
(909) 528-6858
(909) 798-9999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G77453
CA
2083P0901X
Public Health & General Preventive Medicine Physician
G77453
CA
Other
Enumeration date
10/31/2006
Last updated
01/14/2013
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