MEDICARE: PHILIP FISCHBACHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G19479	CA

General Provider Information

NPI Number	:	1467802264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP FISCHBACHER

Provider Business Mailing Address
First Line	:	696 SAN RAMON VALLEY BLVD
Second Line	:	#101
City	:	DANVILLE
State	:	CA
Zip	:	94526-4022
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	696 SAN RAMON VALLEY BLVD
Second Line	:	#101
City	:	DANVILLE
State	:	CA
Zip	:	94526-4022
Country	:	US
Telephone Number	:	925-899-6044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	06/13/2016

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Directions to “ PHILIP FISCHBACHER ” Practice Location

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