DR. DONALD B FULLER (NPI# 1285632711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285632711 |
| Entity Type | Individual |
| Full Name | DR. DONALD B FULLER |
| Credential | M.D. |
| Practice Address |
3366 5th Ave San Diego CA 92103-5713 |
| Mailing Address |
Po Box 33865 San Diego CA 92163-3865 |
| Practice Telephone | 6192300400 |
| Practice Fax Number | 8584297936 |
| Mailing Telephone | 8588887700 |
| Mailing Fax Number | 8588887721 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2020-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | G62532 | CA | Other Service Providers |
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
G62532 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G625320 | 05 | |
| CA | DEA CERTIFICATE | BF0272815 | 01 |
| CA | STATE LICENSE | G62532 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417985540 | Donald M Fuller | Physical Therapist | 6419 Carolina Beach Rd Ste C, Wilmington, NC 28412-3672 | 2006-06-29 |
| 1295863991 | Donald R Fuller | Speech-Language Pathologist | 310 N. Riverpoint Blvd., Box V, Spokane, WA 99202-1675 | 2007-03-02 |
| 1295863587 | Donald Jenkins Fuller | Physician Assistant | 401 N Broadway, Rm 1360 Weinberg Bldg., Baltimore, MD 21231-1146 | 2007-03-01 |
| 1699828822 | Donald Fuller | Physical Therapist | 6900 Beechmont Ave, Cincinnati, OH 45230-2910 | 2007-01-19 |
| Street Address |
3366 5TH AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-5713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225036742 | Tahir Ijaz | Specialist | 3366 5th Ave, San Diego, CA 92103-5713 | 2005-07-08 |
| 1336175272 | Reza Shirazi | Specialist | 3366 5th Ave, San Diego, CA 92103-5713 | 2006-06-23 |
| 1427038553 | Pamela L. Kurtzhals Brown | Surgery | 3366 5th Ave, San Diego, CA 92103-5713 | 2006-01-17 |
| 1760480123 | Damon E Smith | Specialist | 3366 5th Ave, San Diego, CA 92103-5713 | 2005-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447593678 | Heather Michelle Mcgee | Radiology | 3366 Fifth Ave, San Diego, CA 92103-5713 | 2013-04-06 |
| 1235320342 | Henry Chessin | Radiology | 2466 First Ave., Suite B, San Diego, CA 92101-1492 | 2007-08-05 |
| 1104860865 | Francisco S. Pardo Md PC | Radiology | 1855 1st Ave, Suite 200 B, San Diego, CA 92101-2685 | 2006-06-15 |
| 1790724565 | X-ray Medical Group Radiation Oncology Inc | Radiology | 3075 Health Center Drive, Level 0, San Diego, CA 92123 | 2006-06-06 |
| 1871552950 | Atmaram S Paipanandiker | Radiology | 9730 Summers Ridge Rd, San Diego, CA 92121-3101 | 2006-03-20 |
| 1326032129 | Kenneth T Shimizu | Radiology | 10670 John J Hopkins Dr, San Diego, CA 92121-1120 | 2005-09-07 |
| 1093240285 | Proton Doctors Professional Corporation | Radiology | 9730 Summers Ridge Rd, San Diego, CA 92121-3101 | 2017-04-25 |
| 1396107058 | Christine Feng | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2016-03-22 |
| 1801281399 | Christopher Andrew Straka | Radiology | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2015-04-01 |
| 1679815963 | Tyler Michael Seibert | Radiology | 200 W Arbor Dr, San Diego, CA 92103 | 2013-03-25 |
| Find all providers in SAN DIEGO | ||||
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| 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.