Healthcare Provider Details

I. General information

NPI: 1598849788
Provider Name (Legal Business Name): CRAIG FISCHER, MD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 DWIGHT WAY STE 304
BERKELEY CA
94704-2633
US

IV. Provider business mailing address

2006 DWIGHT WAY STE 304
BERKELEY CA
94704-2633
US

V. Phone/Fax

Practice location:
  • Phone: 510-843-2220
  • Fax: 510-843-2227
Mailing address:
  • Phone: 510-843-2220
  • Fax: 510-843-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG025733
License Number StateCA

VIII. Authorized Official

Name: DR. CRAIG FISCHER
Title or Position: OWNER
Credential: M.D.
Phone: 510-843-2220