Healthcare Provider Details

I. General information

NPI: 1962743369
Provider Name (Legal Business Name): JOSHUA JAMES FISCHER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2013
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 PORTER ST STE 17
SOQUEL CA
95073-2453
US

IV. Provider business mailing address

PO BOX 520
APTOS CA
95001-0520
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:
Title or Position:
Credential:
Phone: