Individual provider Active NPI

Peter Norman Fysh, D.C.

  • Chiropractor
  • Sunnyvale, CA
National Provider Identifier
1104044593
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
19790 Issued in CA
Practice address
990 W Fremont Ave
Suite M
Sunnyvale, CA 94087-3021
Phone
(408) 773-9165
Fax
(408) 773-8556
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 19790 CA Primary

Addresses

Primary practice location

990 W Fremont Ave
Suite M
Sunnyvale, CA 94087-3021

Mailing address

5823 Killarney Cir
San Jose, CA 95138-2345
Phone (408) 773-9165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104044593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 KILLARNEY CIR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382345",
            "telephone_number": "408-773-9165",
            "fax_number": "408-773-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W FREMONT AVE",
            "address_2": "SUITE M",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873021",
            "telephone_number": "408-773-9165",
            "fax_number": "408-773-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYSH",
        "first_name": "PETER",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "19790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.