Healthcare Provider Details

I. General information

NPI: 1952806333
Provider Name (Legal Business Name): KNIGHT FISCHER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 CARMELITO AVE
MONTEREY CA
93940-4502
US

IV. Provider business mailing address

174 CARMELITO AVE
MONTEREY CA
93940-4502
US

V. Phone/Fax

Practice location:
  • Phone: 831-920-3838
  • Fax: 831-222-1004
Mailing address:
  • Phone: 831-920-3838
  • Fax: 831-222-1004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number20A15539
License Number StateCA

VIII. Authorized Official

Name: DR. JOSHUA JAMES FISCHER
Title or Position: PRESIDENT
Credential: DO
Phone: 253-569-2562