Gary M Fishberg O D Prof Corp

LBN: Gary M Fishberg O D Prof Corp
Gary M Fishberg O D Prof Corp is an health care organization with primary practice located at 5225 Canyon Crest Dr Suite 201, Riverside CA 92507-6301. The organization recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as the primary health care specialty. Gary M Fishberg O D Prof Corp can be contacted via phone (951) 788-2020, or through Fishberg, Gary M via phone (951) 788-2020.

Contact Information

Primary practice address
5225 Canyon Crest Dr Suite 201 Riverside CA 92507-6301
Phone: (951) 788-2020
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fishberg, Gary M Doctor of Optometry (OD)
Phone: (951) 788-2020

Health care specialties

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

Profile Details

NPI number 1639338312
LBN Legal business name Gary M Fishberg O D Prof Corp
DBA Doing business as
Authorized official Fishberg, Gary M Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2008
Last updated Mar 11th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639338312 NPPES
California MEDICAID SD0066562

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