Provider Demographics
NPI:1154641140
Name:FISCHER, GABRIEL B (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:B
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 CENTER ST
Mailing Address - Street 2:APT 706
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1269
Mailing Address - Country:US
Mailing Address - Phone:207-321-9986
Mailing Address - Fax:
Practice Address - Street 1:3075 ADELINE ST
Practice Address - Street 2:SUITE 280
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2576
Practice Address - Country:US
Practice Address - Phone:207-204-2885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135158207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine