Individual
CELIA ANN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 BROADWAY, SANTA MONICA, CA 90404-2808
(310) 957-0326
Mailing address
1720 BROADWAY, SANTA MONICA, CA 90404-2808
(310) 957-0326
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
4093566
CA
172A00000X
Driver
A13921
CA
172A00000X
Driver
C5729406
CA
172A00000X
Driver
Primary
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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