DR. JON D FULLER (NPI# 1245270412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245270412 |
| Entity Type | Individual |
| Full Name | DR. JON D FULLER |
| Credential | MD |
| Practice Address |
3801 Miranda Ave. Va Palo Alto Hcs Palo Alto CA 94304 |
| Mailing Address |
3801 Miranda Ave. (111) Va Palo Alto Hcs Palo Alto CA 94304 |
| Practice Telephone | 6504935000 |
| Mailing Telephone | 6504935000 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
G68828 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376566976 | Jon Gordon Fuller Jr. | Dentist | 570 W 400 N, Moab, UT 84532-2236 | 2006-07-25 |
| 1225080765 | Jon D Fuller | Surgery | 7 Shackleford West Blvd, Little Rock, AR 72211-3886 | 2006-05-16 |
| 1952387946 | Jon D. Fuller | Family Medicine | 725 Albany Street, Shapiro 9, Suite B, Boston, MA 02118-2526 | 2005-12-21 |
| Street Address |
3801 MIRANDA AVE. VA PALO ALTO HCS |
| City | PALO ALTO |
| State | CA |
| Zip Code | 94304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538114640 | William Otto Faustman | Psychologist | 3801 Miranda Ave., Psychology Service 116b, Palo Alto, CA 94304-1207 | 2006-05-24 |
| 1902344013 | Shady Tawfik | Pharmacist | 3801 Miranda Ave., Pharmacy 119, Palo Alto, CA 94304 | 2017-02-09 |
| 1326404252 | Xuejiao Cui | Speech-Language Pathologist | 3801 Miranda Ave., Palo Alto, CA 94305-1290 | 2016-01-07 |
| 1437543436 | Chih Hsuan Chou | Dentist | 3801 Miranda Ave., Va Palo Alto Health Care System, Dental (160), Palo Alto, CA 94304 | 2015-03-27 |
| 1326442138 | Ursula Rosie Quejado | Nurse's Aide | 3801 Miranda Ave., Palo Alto, CA 94504 | 2014-10-22 |
| 1518118785 | Va Palo Alto Health Care System | Military Hospital | 3801 Miranda Ave., Va Palo Alto Health Care System, Cardiology 111c, Palo Alto, CA 94304-1207 | 2008-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170611 | Richard Engdahl | Specialist/Technologist, Other | 820 Quarry Road, Mc1078 Hf006, Palo Alo, CA 94304 | 2020-07-04 |
| 1720603582 | Lily Wenya Zhou | Psychiatry & Neurology | 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 | 2020-06-08 |
| 1033738521 | Perry Seo Choi | Student in an Organized Health Care Education/Training Program | Dept of Cardiothoracic Surgery, Falk Building, 870 Quarry Rd, Palo Alto, CA 94304 | 2020-04-14 |
| 1073150355 | Tara Mcdermott | Nurse Practitioner | 500 Pasteur Drive, Cardiovascular Intensive Care Unit, Palo Alto, CA 94304 | 2019-12-05 |
| 1811542723 | Mark Henry Chubb | Pediatrics | Stanford Children's Health, 725 Welch Road, Palo Alto, CA 94304 | 2019-08-07 |
| 1194285114 | Cora Steindl | Nurse Practitioner | 300 Pasteur Drive Rm H2512, Stanford, CA 94304 | 2019-03-25 |
| 1407333057 | Deborah Menet Landi | Social Worker | Lucile Packard Children's Hospital Stanford, 725 Welch, Mc 5933, Palo Alto, CA 94304 | 2018-07-26 |
| 1982100798 | Jonathan Hootman | Student in an Organized Health Care Education/Training Program | 900 Quarry Road Extension, Palo Alto, CA 94304 | 2018-04-02 |
| 1093234254 | Adam C Maclellan | Psychiatry & Neurology | Stanford Stroke Center, 780 Welch Road, Suite 350, Palo Alto, CA 94304 | 2017-09-19 |
| 1194248153 | Chanel Beaudoin Cloutier | Plastic Surgery | 770 Welch Road, Suite 400, Palo Alto, CA 94304 | 2017-07-21 |
| Find all providers in zip 94304 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568711430 | Arthur James Small | Internal Medicine | 1515 Castilleja Ave, Palo Alto, CA 94306-1001 | 2012-09-06 |
| 1346506276 | Sowmya Srinivasan Iyer | Internal Medicine | 3801 Miranda Ave # 182b, Palo Alto, CA 94304-1290 | 2012-04-04 |
| 1942248133 | Vj Periyakoil | Internal Medicine | 3801, Miranda Avenue, 100-2c, Palo Alto, CA 94304 | 2006-06-02 |
| 1821225459 | Maria Kristina Pelayo Gestuvo | Internal Medicine | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2009-06-22 |
| 1003951013 | Yusra Nazar Hussain | Internal Medicine | 770 Welch Rd, Suite # 250, Palo Alto, CA 94304-1511 | 2007-02-20 |
| 1457420929 | Malini B Madanahalli | Internal Medicine | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2006-11-07 |
| 1861589228 | John Frank Cesca | Internal Medicine | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2006-10-06 |
| 1104932540 | Bradford Duncan | Internal Medicine | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2006-08-21 |
| 1073629564 | Peter Cheng | Internal Medicine | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2006-08-21 |
| 1982658126 | Gail Gullickson | Internal Medicine | 3801 Miranda Ave, Mailcode 182b, Palo Alto, CA 94304-1207 | 2006-05-20 |
| Find all providers in PALO ALTO | ||||
Please comment or provide details below to improve the information on DR. JON D FULLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.