Jack G. Fuller in Burbank - Physician Assistant
Jack G. Fuller - NPI 1376596668
Jack G. Fuller is a Physician Assistant in Burbank, California. Jack G. Fuller practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jack G. Fuller is 1376596668. The last update date is 2007-07-09.
Jack G. Fuller's current location address is 2550 Northhollywood Way, Burbank, California. You can contact this provider via phone number 8185570135 and fax number 8185571394. The mailing address for Jack G. Fuller is 2550 Northhollywood Way, Burbank, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack G. Fuller |
|---|---|
| Address | 2550 Northhollywood Way, Burbank, California |
| Phone Number | 8185570135 |
| Fax Number | 8185571394 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1376596668 |
|---|---|
| Provider Enumeration Date | 2006-05-18 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 2550 Northhollywood Way |
|---|---|
| City | Burbank |
| State | California (CA) |
| Post Code | 915055019 |
| Phone Number | 8185570135 |
| Fax Number | 8185571394 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA12536 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00198638 | CA | GOOD SAMARITAN RAILROAD | |
| PA12536 | CA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Jack G. Fuller by the Centers for Medicare & Medicaid Services?
The Jack G. Fuller has been assigned the NPI (National Provider Identifier) 1376596668 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Jack G. Fuller is geographically located?
The Jack G. Fuller is physically situated at the following location: 2550 Northhollywood Way, Burbank, CA, 915055019.
What is Jack G. Fuller's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jack G. Fuller's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
On what date did the Jack G. Fuller receive its 1376596668 assignment from the Centers for Medicare & Medicaid Services?
The Jack G. Fuller was assigned its 1376596668 by the Centers for Medicare & Medicaid Services on 2006-05-18.
As of what date were the details related to Jack G. Fuller most recently updated or revised?
The information pertaining to Jack G. Fuller, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-09.