COREY B. FULLER MD – NPI #1053637694
Orthopaedic Surgery

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

Health Care Provider Taxonomy Code for Orthopaedic Surgery

COREY FULLER is an orthopaedic surgeon located in LOMA LINDA, CA. NPPES has assigned the NPI number 1053637694 to COREY FULLER on April 07, 2010. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207XX0005X from the Health Care Provider Taxonomy code set, which is classified as Orthopaedic Surgery, specializing in Sports Medicine

The NPI profile was last updated on Mar 18, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COREY FULLER below.

NPI Profile for
COREY B. FULLER

NPI Number
1053637694
Enumeration Date

(more than 16 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
COREY B. FULLER
Credentials
MD
Primary location
25455 BARTON RD STE 102B
LOMA LINDA, CA 92354-3139
Phone: (909) 558-6444 Fax: (909) 558-6118
1 Other location(s):
450 N Graham St
Portland, OR 97227-1682
Phone: (503) 413-4488
Mailing address
11406 LOMA LINDA DR STE 226
LOMA LINDA, CA 92354-3711
Phone: (909) 558-6644 Fax: (909) 558-6118
Sole Proprietor
No
Updated
Certification Date
Mar 18, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207XX0005X
- Orthopaedic Surgery / Sports Medicine (Primary)		 CA A118405
207X00000X
- Orthopaedic Surgery		 CA A118405

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Endpoint type
SOAP URL
Endpoint Description
CAREQUALITY
Content Type
OTHER
Affiliation
Y
Endpoint Location
9961 SIERRA AVE,
FONTANA, CA 77025-1669

Additional Information

Education
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE - Graduated 2010
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
COREY FULLER is affiliated with the following medical group(s):
  • HOSPITAL
    • LOMA LINDA UNIVERSITY MEDICAL CENTER
      11234 ANDERSON ST
      LOMA LINDA, CA 92354

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.