Provider Demographics
NPI:1659884468
Name:GREGORY T. FISHER, M.D., P.C.
Entity Type:Organization
Organization Name:GREGORY T. FISHER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:T
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-865-9600
Mailing Address - Street 1:17785 CENTER COURT DR N STE 130
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9305
Mailing Address - Country:US
Mailing Address - Phone:562-865-9600
Mailing Address - Fax:
Practice Address - Street 1:17785 CENTER COURT DR N STE 130
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-9305
Practice Address - Country:US
Practice Address - Phone:562-865-9600
Practice Address - Fax:562-865-9612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty