Active NPI
Lucian Fulger
- Pediatric Occupational Therapist
- Beverly Hills, CA
National Provider Identifier
1508134263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 4975
- Practice address
- 9100 Wilshire Blvd
Beverly Hills, CA 90212-3415 - Phone
- (877) 801-6325
- Fax
- (877) 801-6325
- NPI assigned
- Dec 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | 12640 | CA | |
| Pediatric Occupational Therapist | 225XP0200X | 4975 | AZ | Primary |
Addresses
Primary practice location
9100 Wilshire Blvd
Beverly Hills, CA 90212-3415
Mailing address
9100 Wilshire Blvd
Beverly Hills, CA 90212-3415
Phone (877) 801-6325
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12640 | CA | MD | Counselor |
| 4975 | AZ | MD | Child Mental Illness Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407974400000",
"number": "1508134263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9100 WILSHIRE BLVD",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902123415",
"telephone_number": "877-801-6325",
"fax_number": "877-801-6325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 WILSHIRE BLVD",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902123415",
"telephone_number": "877-801-6325",
"fax_number": "877-801-6325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULGER",
"first_name": "LUCIAN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-09",
"last_updated": "2014-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "CA",
"license": "12640",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "AZ",
"license": "4975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.