Individual
CARLA ANNA FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
165 LYNCH CREEK WAY, PETALUMA, CA 94954-2343
(707) 762-5531
(707) 762-5976
Mailing address
500 ALFRED NOBEL DR, SUITE 245, HERCULES, CA 94547-1838
(510) 741-7299
(510) 741-7493
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G63183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070016604
RAILROAD MEDICARE
CA
01
—
G63183
LICENSE NUMBER
CA
Enumeration date
07/07/2005
Last updated
02/20/2015
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