Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E2216 | CA |
Y | 222Z00000X | Podiatrist | E2216 | CA |
N | 213ES0131X | Foot Surgery | E2216 | CA |
NPI | 1265547210 |
---|---|
Provider Name | Arthur James Fisher III |
First Address | Eureka, CA 95503-4541 |
Second Address | Eureka, CA 95503-4541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 14/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E22160 | (05) | CA |
000E22161 | (05) | CA |
T11230 | (02) | CA |