Provider Demographics
NPI:1265450696
Name:FISHMAN, LOUIS S (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:S
Last Name:FISHMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:435 NORTH ROXBURY DR
Mailing Address - Street 2:# 300
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:310-278-5670
Mailing Address - Fax:310-858-1429
Practice Address - Street 1:435 NORTH ROXBURY DR
Practice Address - Street 2:# 300
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-278-5670
Practice Address - Fax:310-858-1429
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG11061207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A90110Medicare UPIN