Provider Demographics
NPI:1649288549
Name:FISCHER, STEVEN J (DC, PA-C)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:FISCHER
Suffix:
Gender:M
Credentials:DC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 SKYWAY
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-5624
Mailing Address - Country:US
Mailing Address - Phone:530-872-2000
Mailing Address - Fax:
Practice Address - Street 1:2685 JOLLY RD
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3553
Practice Address - Country:US
Practice Address - Phone:734-594-7931
Practice Address - Fax:734-464-0335
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15922111N00000X
CAPA20607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC159220Medicaid
CAT05956Medicare UPIN