Individual
TREVAN DALE FISCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 829-8781
(310) 582-7185
Mailing address
2200 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2312
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
135300
CA
208600000X
Surgery Physician
TRN12753
FL
2086X0206X
Surgical Oncology Physician
Primary
135300
CA
Other
Enumeration date
06/05/2008
Last updated
04/21/2023
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