Individual
TED YOSHIO FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
628 G ST, BRAWLEY, CA 92227-2544
(760) 344-1101
Mailing address
628 G ST, BRAWLEY, CA 92227-2544
(972) 822-1957
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
K0033
TX
2086S0129X
Vascular Surgery Physician
Primary
A052523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680560958
TAX ID
TX
Enumeration date
08/08/2006
Last updated
05/09/2016
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