Jay M. Fuller, PT

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

3551 Issued in CA

Practice address

26 Centerpointe Dr
Suite 115
La Palma, CA 90623-1072

Phone

(714) 522-8020

NPI assigned

Jun 12, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1912167040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "800-232-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CENTERPOINTE DR",
            "address_2": "SUITE 115",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231072",
            "telephone_number": "714-522-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JAY",
        "middle_name": "M.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "3551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Foye
• Codi Ki Fredrickson
• Sarah Elizabeth Freels
• Melanie Ann Freeman, MA, BCBA
• Friendly Eye Medical Group Inc
• Lexie M Fuller
• Futurecare Medical Associates Ipa Inc
• Esmeralda Galeno
• Erika Gallardo
• Dulce Gallegos

• Occupational Medicine Physician in La Palma, CA
• Providers in La Palma, CA by specialty
• Occupational Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.