Provider Demographics
NPI:1639166838
Name:FISHMAN, HARVEY ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:ABRAHAM
Last Name:FISHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:706 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2628
Mailing Address - Country:US
Mailing Address - Phone:650-322-4393
Mailing Address - Fax:650-322-1921
Practice Address - Street 1:706 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2628
Practice Address - Country:US
Practice Address - Phone:650-322-4393
Practice Address - Fax:650-322-1921
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA78707207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85459Medicare UPIN