Cole Marie Fulwider, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G37354 Issued in CA

Practice address

3772 Katella Ave.
Suite 206
Los Alamitos, CA 90720-6428

Phone

(562) 430-4294

Fax

(562) 493-3573

NPI assigned

Mar 16, 2006

Last updated

Jun 18, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of California, Irvine, California College of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vipal Soni MD IncGroup PAC ID 0345378113, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vipal Soni M.D., Inc.

  • Dermatology Physician
  • Huntington Beach, CA
  • NPI 1962726331
  Medicare reassignment Care Compare group NPD
• Advanced Skincare Physician Assistant Corporation (Pac)

  • Physician Assistant
  • Fullerton, CA
  • NPI 1245830389
  Medicare reassignment NPD
• Howard Fein MD Inc

  dba Pacific Dermatology Specialists

  • Dermatology Physician
  • Rllng HLS Est, CA
  • NPI 1073795266
  Medicare reassignment NPD
• Sung M.D., a Professional Corporation

  • Dermatology Physician
  • Monterey Park, CA
  • NPI 1972244176
  Medicare reassignment NPD
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• Palos Verdes Skin Surgery Ctr Inc

  dba Palos Verdes Dermatology Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Rolling Hills Estates, CA
  • NPI 1285028803
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1033188560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 KATELLA AVE.",
            "address_2": "SUITE 206",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907206428",
            "telephone_number": "562-430-4294",
            "fax_number": "562-493-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 KATELLA AVE.",
            "address_2": "SUITE 206",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907206428",
            "telephone_number": "562-430-4294",
            "fax_number": "562-493-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULWIDER",
        "first_name": "COLE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G37354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "G37354A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Anne Freijo, MFT
• Sarah Frontiera
• Jean Fu, L.AC., QME.,PH.D.
• Sumina Fukami, M.D.
• Kathleen June Fulmer, ARNP
• Galaxy Investment Pharmacy Inc (Galaxy Pharmacy)
• Gina Gallivan, PH.D.
• Ethel Gannon
• Alison M Garcia, LMFT
• Kevin Joseph Garcia, PPS

• Dermatology Physician in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.