Healthcare Provider Details

I. General information

NPI: 1801837000
Provider Name (Legal Business Name): ROBERT B FISHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBERT B FISHER MD

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 ALAMEDA DE LAS PULGAS AVENUE
REDWOOD CITY CA
94062
US

IV. Provider business mailing address

PO BOX V
MOUNTAIN VIEW CA
94040-0150
US

V. Phone/Fax

Practice location:
  • Phone: 650-369-5811
  • Fax:
Mailing address:
  • Phone: 650-691-0611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG41940
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: