Bertram Fuller PAC

NPI 1073793691 - Physician Assistant - 363AS0400X

NPI Details
NPI 1073793691
Gender Male
Enumeration Date 11/12/2007
Last Updated 11/12/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
7033 STEWART AND GRAY RD UNIT 38
DOWNEY CA, 90241-4355, US
Phone (562) 927-0677
Fax
Business Location
PO BOX 4808
DOWNEY CA, 90241-1808, US
Phone (562) 927-0677
Fax
Toxanomy
Taxonomy Code 363AS0400X
License State California
License Number PA 14719
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According to our database, Bertram Fuller PAC NPI is 1073793691, taxonomy code is 363AS0400X and license number is PA 14719, license state is located at California. Bertram Fuller PAC physically located at 7033 Stewart And Gray Rd Unit 38, Downey CA, 90241-4355. NPI Number Bertram Fuller PAC has the Individual type.

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1073793691 NPI number is provided on an as is basis without warranty of any kind. 1073793691 is maintained by the National Plan & Provider Enumeration System. The contents of Bertram Fuller PAC are for informational purposes only.