Provider Demographics
NPI:1275761959
Name:FITZGERALD, CECILY (MD)
Entity Type:Individual
Prefix:
First Name:CECILY
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4067 TRANSPORT ST STE B
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4914
Mailing Address - Country:US
Mailing Address - Phone:650-384-0986
Mailing Address - Fax:
Practice Address - Street 1:4067 TRANSPORT ST STE B
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4914
Practice Address - Country:US
Practice Address - Phone:650-384-0986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78596207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine