IndividualActive
Jennifer Fuller
NPI 1902149933 · Otolaryngology/Facial Plastic Surgery Physician · Loma Linda, CA
Provider details
- NPI number
- 1902149933
- Entity type
- Individual
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 63479 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
11234 Anderson St # 2586a
Loma Linda, CA 92354-2804
Phone: (909) 558-7884
Approximate (ZIP-level) locationGet directions
Mailing address
11234 Anderson St # 2586a
Loma Linda, CA 92354-2804
Registry dates
- Enumerated
- 2013-03-27
- Last updated
- 2019-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.