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General NPI Number Information
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NPI Number | 1275550709
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Entity Type | Individual
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Provider Name | RICHARD FITZSIMMONS FNP
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1550 SOUTH IMPERIAL AVENUE
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City | EL CENTRO
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State | CA
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Zip | 92243
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Country | US
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Telephone | 760-339-2802
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Fax | 760-355-9520
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Provider Business Mailing Address
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Address Line | 516 WEST ATEN ROAD SUITE 2
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City | IMPERIAL
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State | CA
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Zip | 92251-9805
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Country | US
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Telephone | 760-355-7731
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Fax | 760-355-7731
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN421408
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9393
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License Number State | CA
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