Kelly Blaine Fullerton, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

20978 Issued in CA

Practice address

2110 S Coast Hwy Ste a
Oceanside, CA 92054-6544

Phone

(760) 720-0000

Fax

(760) 687-0017

NPI assigned

Jun 1, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kelly Blaine Fullerton Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1164802633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 S COAST HWY STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546544",
            "telephone_number": "760-720-0000",
            "fax_number": "760-687-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 S COAST HWY STE A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546544",
            "telephone_number": "760-720-0000",
            "fax_number": "760-687-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "KELLY",
        "middle_name": "BLAINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "20978",
            "primary": true
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "CA",
            "license": "20978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FULLERTON",
            "middle_name": "BLAINE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Everett Manuel Fryman, MSW
• Kimberly Sue Fudge, RADT-II
• Jose Fuente, LMFT
• Jessica Sonia Fuentes
• Lauren Fuhs, PHARM D
• Kimberly Fulmer
• Fun Fitness Inc. (Golden Steps Pediatric Therapy)
• Gabrielle Rose Fundora
• Angela Funk, IBCLC
• Raeann Furbush

• Chiropractor in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.