MEDICARE: CRAIG FISCHER, MD MEDICAL CORPORATION

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	2084P0800X	Psychiatry Physician	G025733	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G025733	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1598849788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG FISCHER, MD MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	2006 DWIGHT WAY STE 304
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-2633
Country	:	US
Telephone Number	:	510-843-2220
Fax Number	:	510-843-2227

Provider Business Practice Location Address
First Line	:	2006 DWIGHT WAY STE 304
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94704-2633
Country	:	US
Telephone Number	:	510-843-2220
Fax Number	:	510-843-2227

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CRAIG FISCHER
Credential	:	M.D.
Telephone Number	:	510-843-2220

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	08/06/2007

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