DR. CHARLES ELLIS MOSS FISHER (NPI# 1053320002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053320002 |
| Entity Type | Individual |
| Full Name | DR. CHARLES ELLIS MOSS FISHER |
| Credential | M.D. |
| Practice Address |
12021 S. Wilmington Ave Los Angeles CA 90059 |
| Practice Telephone | 5624275363 |
| Practice Fax Number | 5624278802 |
| Mailing Telephone | 5624275363 |
| Mailing Fax Number | 5624278802 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
G16541 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477969368 | Charles Russell Fisher IIi | Case Manager/Care Coordinator | 266 Hartsville Pike, Carthage, TN 37030-2100 | 2014-07-11 |
| 1306110150 | Charles Russell Fisher | Family Medicine | 86 Columbus Cir Ste 203, Athens, OH 45701-1371 | 2012-02-25 |
| 1699929380 | Charles Howard Fisher | Radiology | 4904 Andros Dr, Tampa, FL 33629-4802 | 2008-11-09 |
| 1063537413 | Charles Ross Fisher | Psychologist | 4770 E Iliff, Suite 111, Denver, CO 80222 | 2007-03-21 |
| 1003961780 | Charles Daniel Fisher | Dentist | 6215 Riverview Crossing Dr Ste C, Knoxville, TN 37924-2839 | 2007-01-24 |
| 1942364559 | Charles David Fisher | Dentist | 5749 Nicollet Ave S, Minneapolis, MN 55419 | 2006-12-20 |
| 1336231265 | Charles E. Fisher Jr. | Ophthalmology | 4613 13th St, Lubbock, TX 79416-4823 | 2006-09-28 |
| 1730725037 | Charles Michael Fisher | Social Worker | 7777 Forest Ln Ste C528, Dallas, TX 75230-6848 | 2019-11-21 |
| 1255897807 | Charles Aaron Fisher | Counselor | 8739 Santa Monica Blvd, West Hollywood, CA 90069-4507 | 2019-02-19 |
| 1023501129 | Charles J. Fisher II | Student in an Organized Health Care Education/Training Program | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2018-06-13 |
| Street Address |
12021 S. WILMINGTON AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790793370 | Xiao-quan Yuan | Neurological Surgery | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-08-03 |
| 1871633826 | Michael Thaddeaus Rayfield | Physician Assistant | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2007-02-07 |
| 1801969365 | Ashis Mandal | Surgery | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-11-15 |
| 1184794133 | Vijay Bhasin | Internal Medicine | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-11-08 |
| 1528138583 | Richard Findlay | Pediatrics | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-11-08 |
| 1285704239 | Vidya Kaushik | Internal Medicine | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-11-08 |
| 1447336557 | Chat V Dang | Emergency Medicine | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-10-31 |
| 1629154745 | Kenneth Lewis | Anesthesiology | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-10-31 |
| 1497831499 | Leo Lundy | Surgery | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-10-31 |
| 1801971072 | Frederick W James | Pediatrics | 12021 S. Wilmington Ave, Los Angeles, CA 90059 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061863 | Karen L. Herbst, Md, PC | Internal Medicine | 12381 Wilshire Blvd Ste 202, Los Angeles, CA 90025-1063 | 2020-04-14 |
| 1245626712 | Kyrstin Lynnice Lane | Internal Medicine | 700 W 7th St Ste S-270d, Los Angeles, CA 90017-3768 | 2015-04-12 |
| 1982907010 | Carol B Teutsch | Internal Medicine | 841 Moon Ave, Los Angeles, CA 90065-4143 | 2010-12-12 |
| 1851694079 | Harry Weisman, M.d., F.a.c.p. | Internal Medicine | 100 Ucla Medical Plz Ste 220, Los Angeles, CA 90024-7004 | 2010-12-09 |
| 1851624878 | Medical and Behavioral Consultants, Inc | Internal Medicine | 415 Gayley Ave, Apt #304, Los Angeles, CA 90024-2008 | 2009-09-09 |
| 1437380789 | Sina Tebi | Internal Medicine | 10519 Tennessee Ave, Los Angeles, CA 90064-2327 | 2009-08-04 |
| 1497914550 | Ines Donangelo | Internal Medicine | 200 Medical Plaza #530, Los Angeles, CA 90095-5442 | 2008-06-04 |
| 1407078215 | Nissar Shah | Internal Medicine | 3265 S. Sepulveda Blvd., #208, Los Angeles, CA 90034 | 2007-05-02 |
| 1356462808 | Rashmi S Mullur | Internal Medicine | 8700 Beverly Blvd, Suite B-131, Division of Endocrinology Cedars Sinai Medical Center, Los Angeles, CA 90048 | 2007-04-03 |
| 1952485773 | Han Kyu Suh | Internal Medicine | 4220w 3rd St, Los Angeles, CA 90020 | 2006-10-25 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90059 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.