Edwin B Fuller MD Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

C26937 Issued in CA

Legal business name

EDWIN B FULLER MD INC

Practice address

655 Euclid Ave
Suite 301
National City, CA 91950-2957

Phone

(619) 267-3020

Fax

(619) 267-4042

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Edwin B. Fuller, MD

Title

Doctor

Phone

(619) 267-3020

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1164586905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 EUCLID AVE",
            "address_2": "SUITE 301",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502957",
            "telephone_number": "619-267-3020",
            "fax_number": "619-267-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 EUCLID AVE",
            "address_2": "SUITE 301",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502957",
            "telephone_number": "619-267-3020",
            "fax_number": "619-267-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN B FULLER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "619-267-3020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "C26937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C26937",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Viray Dumangas, OTD, OTR/L
• Miguel Lorenzo Duque
• Purita Bangasan Ebbay, DMD
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• Hilary Lynn Elkins, NURSE PRACTITIONER

• Orthopaedic Surgery Physician in National City, CA
• Providers in National City, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.