Organization
DR TED Y FISHER A PROFESSIONAL CORPORATION
Active
Other names
Desert Vein Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TED YOSHIO FISHER MD (PRESIDENT)
(972) 822-1957
Entity
Organization
Contact information
Practice address
628 G ST, BRAWLEY, CA 92227-2544
(760) 344-1101
(760) 344-4985
Mailing address
628 G STREET, BRAWLEY, CA 92227
(760) 344-1101
(760) 344-4985
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A52523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00220G
—
TX
Enumeration date
04/06/2016
Last updated
05/19/2016
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