Provider Demographics
NPI:1518999309
Name:SHERMAN DON MD INC
Entity Type:Organization
Organization Name:SHERMAN DON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-557-6364
Mailing Address - Street 1:11100 WARNER AVENUE
Mailing Address - Street 2:# 308
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708
Mailing Address - Country:US
Mailing Address - Phone:714-557-6364
Mailing Address - Fax:
Practice Address - Street 1:17732 BEACH BLVD STE C
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6881
Practice Address - Country:US
Practice Address - Phone:714-557-6364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG13732207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G137320Medicaid
A39072Medicare UPIN
CA00G137320Medicaid