Nicholas S Fuller M D Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G83197 Issued in CA

Legal business name

NICHOLAS S FULLER M D INC

Practice address

8929 Wilshire Blvd Ste 200B
Beverly Hills, CA 90211-1951

Phone

(310) 883-3388

NPI assigned

Dec 21, 2006

Last updated

May 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas S Fuller, MDNPI 1154382463

Title

Authorized Offical

Phone

(310) 208-8333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas S Fuller, MD

  • Pain Medicine (Anesthesiology) Physician
  • Beverly Hills, CA
  • NPI 1154382463
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1841354925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 ROSECRANS AVE STE D357",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663727",
            "telephone_number": "310-883-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 WILSHIRE BLVD STE 200B",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111951",
            "telephone_number": "310-883-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS S FULLER M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "310-208-8333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G83197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Duong Nguyen, PHARMD
• Arthur Ni
• Niche Home Health Care
• Nicholas R. Nikolov, a Medical Corporation
• Nicholas R. Nikolov, M.D.
• Amy Nicole Nichols, MS, FNP-BC
• Cathi Theresa Nicklas, FNP
• Nicola Natsis MD Inc
• Nicolas a. Ravon, DDS, MSD, Inc.
• Nicole M. Tyer, M.D., Inc.

• Anesthesiology Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.