Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A118592 | CA |
NPI | 1275780686 |
---|---|
Provider Name | Dr. Casey Fisher |
First Address | Poway, CA 92064-2060 |
Second Address | Oceanside, CA 92056-3628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2008 |
Last Update Date | 19/12/2018 |