# GARY M FISHBERG O D PROF CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639338312
- **Authorized official:** DR. GARY M FISHBERG O.D. (OPTOMETRIST/OWNER)
- **Authorized official phone:** (951) 788-2020

## Contact information

- **Practice address:** 5225 CANYON CREST DR, SUITE 201, RIVERSIDE, CA 92507-6301
- **Practice address phone:** (951) 788-2020
- **Mailing address:** 5225 CANYON CREST DR, SUITE 201, RIVERSIDE, CA 92507-6301
- **Mailing address phone:** (951) 788-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WC0802X | Corneal and Contact Management Optometrist | 6656T | CA | Yes |

## Other

- **Enumeration date:** 06/06/2008
- **Last updated:** 03/11/2015