Provider Demographics
NPI:1003003401
Name:EDMUND FISHER, M.D.,INC
Entity type:Organization
Organization Name:EDMUND FISHER, M.D.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALINDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-323-6200
Mailing Address - Street 1:4450 CALIFORNIA AVE
Mailing Address - Street 2:PO BOX 314
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1152
Mailing Address - Country:US
Mailing Address - Phone:661-323-6200
Mailing Address - Fax:661-323-6223
Practice Address - Street 1:5301 TRUXTUN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0742
Practice Address - Country:US
Practice Address - Phone:661-323-6200
Practice Address - Fax:661-323-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60418261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ06497ZMedicare PIN
CA00A604181Medicare PIN
CAH38172Medicare UPIN