Healthcare Provider Details

I. General information

NPI: 1184038093
Provider Name (Legal Business Name): MINIMALLY INVASIVE SURGEONS OF NORTH COUNTY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 S MELROSE DR
VISTA CA
92081-8788
US

IV. Provider business mailing address

2385 S MELROSE DR
VISTA CA
92081-8788
US

V. Phone/Fax

Practice location:
  • Phone: 760-300-3647
  • Fax:
Mailing address:
  • Phone: 760-300-3647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: ADAM SAMUEL FIERER
Title or Position: SURGEON
Credential: M.D.
Phone: 760-845-2863