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General NPI Number Information
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NPI Number | 1396074977
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Entity Type | Organization
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Legal Business Name | GREGORY T. FISHER, M.D. PC
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 12/10/2009
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Provider Practice Location Address
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Address Line | 17785 CENTER COURT DR N SUITE 130
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City | CERRITOS
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State | CA
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Zip | 90703-8573
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Country | US
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Telephone | 562-865-9600
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Fax | 562-865-9612
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Provider Business Mailing Address
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Address Line | 17785 CENTER COURT DR N SUITE 130
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City | CERRITOS
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State | CA
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Zip | 90703-8573
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Country | US
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Telephone | 562-865-9600
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Fax | 562-865-9612
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY T FISHER
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Credential |
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Telephone | 562-865-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | G44251
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License Number State | CA
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