Active NPI
Catherine G Fuller, M.D.
- Allergy & Immunology Physician
- Los Angeles, CA
National Provider Identifier
1851349120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- A43782
- Practice address
- 11645 Wilshire Blvd
Suite 1150
Los Angeles, CA 90025-1708 - Phone
- (310) 828-7978
- Fax
- (310) 909-1911
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | A43782 | CA | Primary |
Addresses
Primary practice location
11645 Wilshire Blvd
Suite 1150
Los Angeles, CA 90025-1708
Mailing address
11645 Wilshire Blvd
Suite 1150
Los Angeles, CA 90025-1708
Phone (310) 828-7978
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WA43782F | Other | CA | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 24, 2015 through Sep 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A43782 | CA | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Immunology and Ige Medical Inc. | Allergy & Immunology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Allergy & Immunology Physician
- Los Angeles, CA
- NPI 1114190584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278547200000",
"number": "1851349120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11645 WILSHIRE BLVD",
"address_2": "SUITE 1150",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251708",
"telephone_number": "310-828-7978",
"fax_number": "310-909-1911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11645 WILSHIRE BLVD",
"address_2": "SUITE 1150",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251708",
"telephone_number": "310-828-7978",
"fax_number": "310-909-1911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "CATHERINE",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2010-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "CA",
"license": "A43782",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "WA43782F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.