MEDICARE: DR. ROBERT STEPHEN FISHMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	G775997	CA

General Provider Information

NPI Number	:	1508127176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT STEPHEN FISHMAN MD

Provider Business Mailing Address
First Line	:	3280 BAYSHORE BLVD
Second Line	:
City	:	BRISBANE
State	:	CA
Zip	:	94005-1021
Country	:	US
Telephone Number	:	415-466-2389
Fax Number	:	650-618-1484

Provider Business Practice Location Address
First Line	:	3280 BAYSHORE BLVD
Second Line	:
City	:	BRISBANE
State	:	CA
Zip	:	94005-1021
Country	:	US
Telephone Number	:	415-466-2389
Fax Number	:	650-618-1484

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2012
Last Update Date	:	05/31/2012

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