Provider Demographics
NPI:1699777334
Name:FISHER, JOHN HH (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HH
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1007 W AVENUE M14
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1443
Mailing Address - Country:US
Mailing Address - Phone:661-265-7019
Mailing Address - Fax:661-265-7089
Practice Address - Street 1:1007 W AVENUE M14
Practice Address - Street 2:SUITE B-1
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1443
Practice Address - Country:US
Practice Address - Phone:661-265-7019
Practice Address - Fax:661-265-7089
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2011-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA41776207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85704Medicare UPIN
CAW13839Medicare ID - Type Unspecified