| NPI | 1558443440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES L. FULBECK Physician 805-549-9533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA G50143) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |