David G Fuller MD a Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DAVID G FULLER MD A PROFESSIONAL CORPORATION

Doing business as

David G Fuller MD A Prof Corp

Practice address

10468 Saint Andrews CT
Oakdale, CA 95361-7602

Phone

(209) 630-1531

NPI assigned

Nov 25, 2021

Last updated

Nov 25, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Glenn Fuller, MDNPI 1033149448

Title

Ceo

Phone

(209) 605-4497

Specialties & licenses 2

Addresses

Other names 1

• David G Fuller MD A Prof Corp Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David G Fuller, M.D.

  • Family Medicine Physician
  • Oakdale, CA
  • NPI 1033149448
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1637798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637798400000",
    "number": "1083371934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10468 SAINT ANDREWS CT",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953617602",
            "telephone_number": "209-630-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10468 SAINT ANDREWS CT",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953617602",
            "telephone_number": "209-630-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID G FULLER MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-25",
        "last_updated": "2021-11-25",
        "certification_date": "2021-11-25",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-605-4497",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David G Fuller MD A Prof Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Theodore J Cummins, DC
• Erika Lynn Curtis, SLP
• D P Patel MD Medical Corp
• Sheila Marie Daniel
• David a. Olson, MD, a Professional Corporation
• Rebecca J. Day, PA - FNP
• Michael A. Dayan, MD
• Lewis Michael Deldebbio
• Paul S. Depaulo, MD
• Rachel Dickerson

• Family Medicine Physician in Oakdale, CA
• Providers in Oakdale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.