ELIZABETH WAGNER FULP PA
NPI 1548994171
Physician Assistant - Medical in San Diego, CA
About Elizabeth Wagner Fulp Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELIZABETH WAGNER FULP PA (NPI 1548994171) is an individual medical provider in San Diego, California, licensed in California (PA64929) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elizabeth Wagner Fulp Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92123
SAN DIEGO, CA 92123
SAN DIEGO, CA 92123
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Elizabeth Fulp's NPI number?
The NPI number for Elizabeth Fulp is 1548994171. It was assigned to this individual provider in the NPPES registry on July 11, 2022.
Where is Elizabeth Fulp located?
Elizabeth Fulp practices at 3020 Childrens Way, San Diego, CA 92123. The listed phone number is (858) 966-8800.
What is Elizabeth Fulp's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Elizabeth Fulp enrolled in Medicare?
Yes. Elizabeth Fulp is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Elizabeth Fulp was last updated on November 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Elizabeth Wagner Fulp, PA · NPI 1548994171
Medical physician in San Diego, California. Individual provider, active in the CMS NPPES registry since July 11, 2022.
## Identity
- **NPI:** 1548994171 (Entity type: Individual)
- **Enumerated:** July 11, 2022
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA64929 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3020 CHILDRENS WAY, San Diego, CA 92123-4223
- **Phone:** (858) 966-8800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** November 4, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1548994171) · Data from the CMS NPPES public registry.