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Dr. Clark Beeman Fuller, MD
Specialist in Los Angeles, California
NPI 1790890341

Clark Beeman Fuller is a Specialist based in Los Angeles, CA. Clark Beeman Fuller practices in Los Angeles, CA and has the professional credentials of MD. The NPI Number for Clark Beeman Fuller is 1790890341 and holds a License No. G76647 (California).

The current practice location address for Clark Beeman Fuller is 8635 W 3Rd St, Los Angeles, CA and can be reached out via phone at 310-652-0530 and via fax at 310-652-9936.

Location: 8635 W 3Rd St, Los Angeles, CA, 90048-6101
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790890341
Provider Name
Clark Beeman Fuller
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
8635 W 3Rd St, Los Angeles, CA, 90048-6101
Phone Number
310-652-0530
Fax Number
310-652-9936
Provider Enumeration Date
08/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GR0091070 05 CA
institution
Provider Business Practice Location Address Details
Address
8635 W 3Rd St
City
Los Angeles
State
California
Zip
90048-6101
Phone Number
310-652-0530
Fax Number
310-652-9936
person
Provider Business Mailing Address Details
Address
8635 W 3Rd St
City
Los Angeles
State
California
Zip
90048-6101
Phone Number
310-652-0530
Fax Number
310-652-9936
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
G76647 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Speciality
-
Taxonomy
208G00000X
License No.
G76647 (California)
Definition
A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
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