Healthcare Provider Details

I. General information

NPI: 1316919731
Provider Name (Legal Business Name): JOAN FISHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WELCH RD SUITE 300
PALO ALTO CA
94304-1811
US

IV. Provider business mailing address

1804 EMBARCADERO RD STE 100
PALO ALTO CA
94303-3341
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-5535
  • Fax: 650-723-2231
Mailing address:
  • Phone: 650-497-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number0101-055934
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number72808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: