Individual
GLENN MARK FISCHBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
31700 TEMECULA PKWY, TEMECULA, CA 92592-5896
(951) 331-2200
Mailing address
3131 LACANADA STREET, SUITE 101, LAS VEGAS, NV 89169-2592
(702) 731-8115
(702) 784-7844
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
G83991
CA
2084N0400X
Neurology Physician
Primary
G83991
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100507939
—
NV
05
—
1093784951
—
AZ
05
—
1093784951
—
CA
05
—
1093784951
—
NV
05
—
1093784951
—
UT
05
—
981440
—
AZ
05
—
XPY205010
—
CA
Enumeration date
03/14/2006
Last updated
08/16/2022
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