Provider Demographics
NPI:1669798906
Name:FISHER, CHERI DAWN (DC)
Entity type:Individual
Prefix:DR
First Name:CHERI
Middle Name:DAWN
Last Name:FISHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 EUCLID ST APT 21
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3329
Mailing Address - Country:US
Mailing Address - Phone:310-962-3255
Mailing Address - Fax:
Practice Address - Street 1:2510 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3333
Practice Address - Country:US
Practice Address - Phone:424-261-5051
Practice Address - Fax:310-760-2033
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11733111NR0400X, 111N00000X, 111NN1001X, 111NS0005X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA166979806OtherNPPES