Provider Demographics
NPI:1619083615
Name:FLEISCHMAN, HORACIO SILVIO (MD)
Entity Type:Individual
Prefix:DR
First Name:HORACIO
Middle Name:SILVIO
Last Name:FLEISCHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 MATILIJA AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2422
Mailing Address - Country:US
Mailing Address - Phone:818-399-0996
Mailing Address - Fax:818-784-5546
Practice Address - Street 1:4036 WHITTIER BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2526
Practice Address - Country:US
Practice Address - Phone:323-796-0500
Practice Address - Fax:323-796-0558
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41069208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A410690Medicaid
CA126550OtherR.H.C
1619083615OtherANTHEM BLUE CROSS/ BLUE SHIELD OF CALIFORNIA
CA00A410690Medicaid
CA126550OtherR.H.C