Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | G44121 | CA |
NPI | 1639174576 |
---|---|
Provider Name | Dr. Alan Jeffrey Fisher |
First Address | Arcadia, CA 91007-9246 |
Second Address | Arcadia, CA 91007-9246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 11/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G441210 | (05) | CA |
A49559 | (02) | CA |