Physician Compare National (NPI:1215934096)

HEALTHCARE PROVIDER: CARLA ANNA FISHER M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1215934096
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9537216163
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090505000180
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FISHER
	Individual professional last name
Provider First Name	CARLA
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIFORMED SERVICES UHS FE HEBERT SCHOOL OF MED
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	EITAN HOMA MD AND JENNIFER KRASNOFF MD INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	5890735856
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	500 ALFRED NOBEL DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 245
	Group Practice or individual's line 2 address
City	HERCULES
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945471843
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5107417418
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y