Healthcare Provider Details

I. General information

NPI: 1407819592
Provider Name (Legal Business Name): LEE HOWARD FISHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE DIAGNOSTIC IMAGING DEPARTMENT
SAN JOSE CA
95128-2604
US

IV. Provider business mailing address

16 BLUE GROUSE CT
BOZEMAN MT
59715-0648
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-6370
  • Fax:
Mailing address:
  • Phone: 406-522-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA46002
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG34614
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: