Michael Charles Fuller JR.
NPI #1083084115 in Beaumont, California
Provider Information
- NPI Number
- 1083084115
- Entity Type
- Individual
- Name
- Michael Charles Fuller JR.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Rehabilitation Practitioner
- Enumeration Date
- Oct 1, 2015
- Last Updated
- Aug 21, 2025
Practice Location
- Address
- 14763 MANZANITA RD
- City
- Beaumont
- State
- California
- ZIP Code
- 92223-3026
- Phone
- (909) 433-9824
Specialties & Taxonomy Codes
| Specialty |
|---|
| Rehabilitation Practitioner |
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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