Organization
JACK E FISHER DPM INC
Active
Other names
Gavilan Foot Care
Organization subpart
No
Provider details
NPI number
Authorized official
JACK FISHER DPM (OWNER/PHYSICIAN)
(408) 842-0281
Entity
Organization
Contact information
Practice address
80 5TH ST, GILROY, CA 95020-5702
(408) 842-0281
(408) 848-4341
Mailing address
80 5TH ST, GILROY, CA 95020-5702
(408) 842-0281
(408) 848-4341
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E1702
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629072392
INDIVIDUAL NPI
CA
01
—
1780794644
GROUP NPI
CA
01
—
E1702
LICENSE
CA
Enumeration date
08/30/2006
Last updated
08/27/2014
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