Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G57438 | CA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | G57438 | CA |
NPI | 1124015409 |
---|---|
Provider Name | Scott P Fischer |
First Address | Orange, CA 92856-6905 |
Second Address | Orange, CA 92868-3852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 24/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A94085 | (02) |