Healthcare Provider Details

I. General information

NPI: 1619083615
Provider Name (Legal Business Name): HORACIO SILVIO FLEISCHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4036 WHITTIER BLVD SUITE 200
LOS ANGELES CA
90023-2526
US

IV. Provider business mailing address

4851 MATILIJA AVE
SHERMAN OAKS CA
91423-2422
US

V. Phone/Fax

Practice location:
  • Phone: 323-796-0500
  • Fax: 323-796-0558
Mailing address:
  • Phone: 818-399-0996
  • Fax: 818-784-5546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA41069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: