Healthcare Provider Details

I. General information

NPI: 1326609496
Provider Name (Legal Business Name): ALLIANCE HOSPITALIST MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 E SOUTH ST STE 307
LAKEWOOD CA
90805
US

IV. Provider business mailing address

3300 E SOUTH ST STE 307
LAKEWOOD CA
90805-4598
US

V. Phone/Fax

Practice location:
  • Phone: 562-630-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: RONALD FISHMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 562-630-3111