Individual
BROCK C. FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3626 RUFFIN RD, SAN DIEGO, CA 92123-1810
(858) 565-9666
(858) 565-9441
Mailing address
3626 RUFFIN RD, SAN DIEGO, CA 92123-1810
(858) 565-9666
(858) 565-9441
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G55342
CA
207LP3000X
Pediatric Anesthesiology Physician
Primary
G55342
CA
2080P0203X
Pediatric Critical Care Medicine Physician
G55342
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G553420
BLUE SHIELD OF CA
CA
05
—
00G553420
—
CA
Enumeration date
06/26/2006
Last updated
12/05/2007
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