Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A41467 | CA |
NPI | 1073689832 |
---|---|
Provider Name | Hugh Price Fulmer |
First Address | Long Beach, CA 90815-0606 |
Second Address | Lynwood, CA 90262-2643 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2006 |
Last Update Date | 11/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A41467 | (02) | CA |