Provider Demographics
NPI:1578732673
Name:MICHAEL D. FISS MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL D. FISS MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL-DENNIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:FISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-436-0871
Mailing Address - Street 1:PO BOX 3764
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93650-3764
Mailing Address - Country:US
Mailing Address - Phone:559-436-0871
Mailing Address - Fax:
Practice Address - Street 1:2828 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4331
Practice Address - Country:US
Practice Address - Phone:559-734-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty