Provider Demographics
NPI:1336560515
Name:FISHER, CHRISTOPHER GORDON (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GORDON
Last Name:FISHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 N PALM AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1900
Mailing Address - Country:US
Mailing Address - Phone:559-432-0606
Mailing Address - Fax:559-432-0608
Practice Address - Street 1:5430 N PALM AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1900
Practice Address - Country:US
Practice Address - Phone:559-432-0606
Practice Address - Fax:559-432-0608
Is Sole Proprietor?:No
Enumeration Date:2013-12-14
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14832152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist