Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | C33232 | CA |
NPI | 1194896829 |
---|---|
Provider Name | William J Fisher |
First Address | Westlake Village, CA 91361-3769 |
Second Address | Westlake Village, CA 91361-3769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A35205 | (02) | CA |