Fishberg, Gary Martin

Fishberg, Gary Martin is an sole proprietor health care provider with primary practice located at 5225 Canyon Crest Dr Ste 201 , Riverside CA 92507-6323. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Corneal and Contact Management is his primary health care specialty. Fishberg, Gary Martin can be contacted via phone (951) 788-2020.

Contact Information

Primary practice address
5225 Canyon Crest Dr Ste 201 Riverside CA 92507-6323
Fax: (951) 684-2020
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 6656 California
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 6656T California

Profile Details

NPI number 1891837852
LBN Legal business name Fishberg, Gary Martin
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2007
Last updated Feb 12th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891837852 NPPES
California MEDICAID SD0066562

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