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GARY M FISHBERG O D PROF CORP NPI 1639338312


NPI Information

NPI: 1639338312
Provider Name: GARY M FISHBERG O D PROF CORP
Classification: Optometrist - 152WC0802X
Entity Type: Organization

Specialization: Corneal and Contact Management

Address:
5225 CANYON CREST DR
SUITE 201
RIVERSIDE, CA
ZIP 92507
Phone: (951) 788-2020
Get Directions

GARY M FISHBERG O D PROF CORP is a corneal and contact management optometrist in Riverside, CA. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. GARY M FISHBERG O D PROF CORP NPI is 1639338312. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5225 CANYON CREST DR
SUITE 201
RIVERSIDE, CA
ZIP 92507-301
Phone: (951) 788-2020

The provider's authorized official is Gary M Fishberg .
The authorized official title is Optometrist/owner and has the following contact phone number (951) 788-2020.

The enumeration date for this NPI number is 6/6/2008 and was last updated on 3/11/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152WC0802XOptometristCorneal and Contact Management6656TCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16276031MEDICARE PINCALIFORNIA
2SD0066562MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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