Provider Demographics
NPI:1669511846
Name:MARTIN FLEISHMAN MD INC
Entity Type:Organization
Organization Name:MARTIN FLEISHMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-673-9934
Mailing Address - Street 1:909 HYDE ST.
Mailing Address - Street 2:STE 620
Mailing Address - City:S.F.
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-673-9934
Mailing Address - Fax:415-673-9957
Practice Address - Street 1:909 HYDE ST.
Practice Address - Street 2:STE 620
Practice Address - City:S.F.
Practice Address - State:CA
Practice Address - Zip Code:94109
Practice Address - Country:US
Practice Address - Phone:415-673-9934
Practice Address - Fax:415-673-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA201192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A201190Medicaid
CA00A201190Medicare ID - Type Unspecified
CA00A201190Medicaid