Fisher, David Edison

Fisher, David Edison is an sole proprietor health care provider with primary practice located at 1850 S. Waterman Ave, Suite E, San Bernardino CA 92408. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Fisher, David Edison can be contacted via phone (909) 890-0977.

Contact Information

Primary practice address
1850 S. Waterman Ave, Suite E San Bernardino CA 92408
Fax: (909) 382-4523
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A36514 California

Profile Details

NPI number 1093811622
LBN Legal business name Fisher, David Edison
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2006
Last updated Jul 8th, 2007 - about 17 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 1093811622 NPPES
California MEDICAID GR0077430
California Other A36514

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