Provider Demographics
NPI:1316919731
Name:FISHER, JOAN (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 EMBARCADERO RD
Mailing Address - Street 2:STE 100
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3341
Mailing Address - Country:US
Mailing Address - Phone:650-497-8000
Mailing Address - Fax:
Practice Address - Street 1:1000 WELCH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1811
Practice Address - Country:US
Practice Address - Phone:650-723-5535
Practice Address - Fax:650-723-2231
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-0559342080P0207X
CA728082080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6718736Medicaid
VA6718736Medicaid
001933C52Medicare PIN