Provider Demographics
NPI:1184181299
Name:FISHER, WILLIAM RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RYAN
Last Name:FISHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-2539
Mailing Address - Country:US
Mailing Address - Phone:415-563-3800
Mailing Address - Fax:415-292-7911
Practice Address - Street 1:1545 BROADWAY
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-2539
Practice Address - Country:US
Practice Address - Phone:415-563-3800
Practice Address - Fax:415-292-7911
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34254111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor