Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | G22239 | CA |
NPI | 1063422178 |
---|---|
Provider Name | Michael B Fisher |
First Address | Santa Barbara, CA 93101 |
Second Address | Santa Barbara, CA 93101-2522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A41517 | (02) | |
GR0016900 | (05) | CA |