# DR TED Y FISHER A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DESERT VEIN CLINIC
- **Other names:** Desert Vein Clinic ASC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154873362
- **Legal business name:** DESERT VEIN CLINIC
- **Authorized official:** DR. TED YOSHIO FISHER MD MD (CEO & PRESIDENT)
- **Authorized official phone:** (619) 905-1164

## Contact information

- **Practice address:** 628 G ST, BRAWLEY, CA 92227-2544
- **Practice address phone:** (760) 344-1101
- **Mailing address:** 608 G ST, BRAWLEY, CA 92227-2568
- **Mailing address phone:** (760) 344-1102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A052523 | CA | Yes |

## Other

- **Enumeration date:** 11/04/2016
- **Last updated:** 11/04/2016