Individual
DR. DAVID LEE FULLER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11833 WILMINGTON AVE, LOS ANGELES, CA 90059-3015
(323) 318-0442
Mailing address
3217 OVERLAND AVE APT 7120, LOS ANGELES, CA 90034-4529
(419) 346-3583
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A162126
CA
207RI0200X
Infectious Disease Physician
Primary
A162126
CA
208000000X
Pediatrics Physician
A162126
CA
Other
Enumeration date
04/09/2015
Last updated
06/07/2022
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