Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A119112 | CA |
N | 111NI0900X | Internist | A119112 | CA |
Y | 207RI0200X | Infectious Disease | A119112 | CA |
NPI | 1003117557 |
---|---|
Provider Name | Dr. Jennifer A Fulcher |
First Address | Los Angeles, CA 90095-3075 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2010 |
Last Update Date | 14/11/2016 |