Healthcare Provider Details

I. General information

NPI: 1780725366
Provider Name (Legal Business Name): HOWARD A. FISHBEIN M.D, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BARRANCA PKWY 202
IRVINE CA
92604-4671
US

IV. Provider business mailing address

PO BOX 15877
NEWPORT BEACH CA
92659-5877
US

V. Phone/Fax

Practice location:
  • Phone: 949-552-2700
  • Fax: 949-552-2087
Mailing address:
  • Phone: 949-574-4600
  • Fax: 949-574-4680

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: DR. HOWARD A FISHBEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 949-552-2700