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NPI Code Detail

MEDICARE: MELODY REBECCA FULTON DO

MEDICARE: MELODY REBECCA FULTON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician20A20336CA

General Provider Information

NPI Number : 1679153704
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELODY REBECCA FULTON DO
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-301-8707
Fax Number :
Provider Business Practice Location Address
First Line : 111 E VICTORIA ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93101-2018
Country : US
Telephone Number : 805-564-3233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2021
Last Update Date : 08/30/2024

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Directions to “ MELODY REBECCA FULTON DO” Practice Location

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