Kylie Fuller MD Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

KYLIE FULLER MD INC

Practice address

250 W Bonita Ave Ste 100
Pomona, CA 91767-1863

Phone

(412) 327-1596

NPI assigned

Jul 10, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kylie A Fuller, MDNPI 1598224875

Title

Owner

Phone

(909) 392-2002

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Kylie A Fuller, MD

  • Obstetrics & Gynecology Physician
  • Greenbrae, CA
  • NPI 1598224875
  Medicare reassignment NPD Authorized official
• Theophilus Mason, FNP

  • Family Nurse Practitioner
  • Pomona, CA
  • NPI 1205580701
  Medicare reassignment NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1891473872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W BONITA AVE STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W BONITA AVE STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671863",
            "telephone_number": "412-327-1596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 W Bonita Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671865",
            "country_code": "US",
            "telephone_number": "909-392-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KYLIE FULLER MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "KYLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-392-2002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Kwak
• Philip Kwok, O.D.
• Christine Kwon, MD
• Jeehee Kwon, SLPA
• Justin Kyinn
• Donna Alyse La Mothe
• Josephine La
• Vy Thoai La, DO
• Ashley Labarre
• Gary Laborada

• Obstetrics & Gynecology Physician in Pomona, CA
• Providers in Pomona, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.