Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A90665 | CA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | ME 96746 | FL |
N | 207YP0228X | Pediatric Otolaryngology | A90665 | CA |
N | 207YP0228X | Pediatric Otolaryngology | ME 96746 | FL |
N | 207YS0123X | Facial Plastic Surgeon | A90665 | CA |
N | 207YS0123X | Facial Plastic Surgeon | ME 96746 | FL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | A90665 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | ME96746 | FL |
N | 208200000X | Surgeon | A90665 | CA |
N | 208600000X | Surgeon | A90665 | CA |
N | 208200000X | Surgeon | ME96746 | FL |
N | 208600000X | Surgeon | ME96746 | FL |
N | 2082S0105X | Plastic Hand Surgeon | A90665 | CA |
N | 2082S0105X | Plastic Hand Surgeon | ME96746 | FL |
NPI | 1649476359 |
---|---|
Provider Name | Dr. Jonathan George Robert Samuel Fisher |
First Address | Orinda, CA 94563-3026 |
Second Address | Orinda, CA 94563-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 08/07/2007 |