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General NPI Number Information
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NPI Number | 1871913442
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Entity Type | Organization
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Legal Business Name | JEREMY FISCHER
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 2001 S BARRINGTON AVE STE 312
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City | LOS ANGELES
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State | CA
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Zip | 90025-5379
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Country | US
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Telephone | 424-278-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 7314 VISTA DEL MAR LN
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-7653
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Country | US
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Telephone | 347-744-8000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEREMY S FISCHER
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Credential | ND, L.AC
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Telephone | 347-744-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC15405
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND570
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License Number State | CA
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