Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles O Fullenwider, MD

Individual provider Pain Medicine (Anesthesiology) Physician · NPI 1417299298

Charles O Fullenwider, MD is an Anesthesiology in San Diego, California. Graduated from University of Oklahoma College of Medicine in 2013, 13 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
13
Trained at
University of Oklahoma College of Medicine
Licensed in
OK
In the registry since
2013
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone: (619) 532-8937
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 8901 Rockville Pike, Bethesda, MD 20889-0001 — (301) 295-4000
  • 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 — (405) 734-2778

Specialties & licences

Pain Medicine (Anesthesiology) Physician (primary) Taxonomy 207LP2900X · Licence 31587 (OK)
Anesthesiology Physician Taxonomy 207L00000X · Licence 31587 (OK)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1417299298
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 20, 2013
Last updated in NPPESMay 27, 2025
Certification dateDecember 12, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolUNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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