Basic Information
| Provider Information | |||||||||
| NPI: | 1801842943 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FISCHER | ||||||||
| FirstName: | SEAN | ||||||||
| MiddleName: | ADAM | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2021 SANTA MONICA BLVD | ||||||||
| Address2: | SUITE 400E | ||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104535654 | ||||||||
| FaxNumber: | 3104536885 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021 SANTA MONICA BLVD STE 400E | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104535654 | ||||||||
| FaxNumber: | 3104536885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 03/31/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | A95048 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.