Healthcare Provider Details

I. General information

NPI: 1003095357
Provider Name (Legal Business Name): JOHN L SHERMAN MD AMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8635 W 3RD ST STE 485W
LOS ANGELES CA
90048-6156
US

IV. Provider business mailing address

8635 W 3RD ST STE 485W
LOS ANGELES CA
90048-6156
US

V. Phone/Fax

Practice location:
  • Phone: 310-855-8081
  • Fax: 310-855-0438
Mailing address:
  • Phone: 310-855-8081
  • Fax: 310-855-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG29916
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG29916
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ALEX ALCARAZ
Title or Position: ASSISTANT
Credential:
Phone: 310-855-8081