Healthcare Provider Details

I. General information

NPI: 1689629487
Provider Name (Legal Business Name): HOWARD A FISHBEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BARRANCA PKWY STE 103
IRVINE CA
92604-4630
US

IV. Provider business mailing address

PO BOX 2218
SUISUN CITY CA
94585-5218
US

V. Phone/Fax

Practice location:
  • Phone: 949-552-2700
  • Fax: 949-552-2701
Mailing address:
  • Phone: 657-241-3600
  • Fax: 657-241-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA31254
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: