Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | A96870 | CA |
Y | 2081P2900X | Pain Medicine | A96870 | CA |
NPI | 1346515319 |
---|---|
Provider Name | Dr. Carl Walter Fieser JR. |
First Address | Walnut Creek, CA 94598-2408 |
Second Address | Walnut Creek, CA 94598-2408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2012 |
Last Update Date | 13/09/2012 |