Individual
DR. PETER FISCHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAL
Contact information
Practice address
16130 KOKANEE ROAD, STE 103, APPLE VALLEY, CA 92307
(760) 242-0762
(760) 242-0762
Mailing address
16130 KOKANEE ROAD, STE 103, APPLE VALLEY, CA 92307
(760) 242-0762
(760) 242-0762
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A33580
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
A33580
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A335801
—
CA
01
—
020050095
RAILROAD MEDICARE
CA
01
—
330324608
TRICARE
—
Enumeration date
10/24/2006
Last updated
10/23/2008
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