NPIMap

Organization Active NPI

Susan L Fullemann MD

  • Specialist
  • Burlingame, CA
National Provider Identifier
1497824262
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G51875 Issued in CA
Legal business name
SUSAN L FULLEMANN MD
Practice address
1820 Ogden Dr
1St Floor
Burlingame, CA 94010-5384
Phone
(650) 697-7202
Fax
(650) 697-7059
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Authorized official

Name
Dr. Susan L Fullemann, M.D.
Title
Medical Director
Phone
(650) 697-7202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G51875 CA Primary

Addresses

Primary practice location

1820 Ogden Dr
1St Floor
Burlingame, CA 94010-5384

Mailing address

1820 Ogden Dr
1St Floor
Burlingame, CA 94010-5384
Phone (650) 697-7202

Other names 1

  • BURLINGAME FAMILY HEALTH MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

1820 Ogden Dr
Ste 100
Burlingame, CA 94010
Phone (415) 692-8090

1820 Ogden Dr
Rm 2
Burlingame, CA 94010

1820 Ogden Dr
#1
Burlingame, CA 94010
Phone (650) 697-7202

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2948/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344988800000",
    "number": "1497824262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 OGDEN DR",
            "address_2": "1ST FLOOR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105384",
            "telephone_number": "650-697-7202",
            "fax_number": "650-697-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 OGDEN DR",
            "address_2": "1ST FLOOR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940105384",
            "telephone_number": "650-697-7202",
            "fax_number": "650-697-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN L FULLEMANN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-08-15",
        "status": "A",
        "authorized_official_last_name": "FULLEMANN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "650-697-7202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G51875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BURLINGAME FAMILY HEALTH MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.