Edwin B Fuller, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

C26937 Issued in CA

Practice address

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

Phone

(619) 267-3020

Fax

(619) 267-4042

NPI assigned

Jul 29, 2005

Last updated

Aug 25, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Edwin B Fuller MD Inc

  • Orthopaedic Surgery Physician
  • National City, CA
  • NPI 1164586905
  Authorized official Same address or phone

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1306846498",
    "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": {
        "last_name": "FULLER",
        "first_name": "EDWIN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "C26937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "C26937",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C269370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hanna Dale Foley, D.P.T.
• Tierra S Ford
• Donald Neal Freeman, O.D.
• Blanca I Fresno, M.D.
• Nohemi Fuentes Vega
• Sabrina Gaba, MS, OTR/L
• John Steve Gachupin, CADC-II
• Khalil Gaieb, PHARMD
• Andrew Sibal Galang, DMD
• Jane Sibal Galang, D.D.S.

• 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 Aug 25, 2011; 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.