Individual
BYRON FISK LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 SIERRA COLLEGE DR STE 170, GRASS VALLEY, CA 95945-5083
(530) 273-4376
(530) 273-6426
Mailing address
300 SIERRA COLLEGE DR STE 170, GRASS VALLEY, CA 95945-5083
(530) 273-4376
(530) 273-6426
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G58831
CA
Other
Enumeration date
02/01/2007
Last updated
02/20/2014
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