Individual
JAMES W FISGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
999 SAN BERNARDINO RD, UPLAND, CA 91786-4920
(909) 985-2811
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(818) 340-9988
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G43073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G430730
BLUE SHIELD
CA
05
—
00G430730
—
CA
Enumeration date
07/25/2006
Last updated
07/08/2007
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