Provider Demographics
NPI:1346085602
Name:STEVEN FISH MD INC
Entity type:Organization
Organization Name:STEVEN FISH MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-402-0540
Mailing Address - Street 1:277 RODNEY AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2901
Mailing Address - Country:US
Mailing Address - Phone:804-402-0540
Mailing Address - Fax:
Practice Address - Street 1:161 THUNDER DR STE 208
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6052
Practice Address - Country:US
Practice Address - Phone:804-402-0540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-28
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Multi-Specialty