Healthcare Provider Details

I. General information

NPI: 1295903631
Provider Name (Legal Business Name): RONALD ARLEN SHERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W 17TH ST
SANTA ANA CA
92706-2316
US

IV. Provider business mailing address

36 UREY CT
IRVINE CA
92617-4045
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-7991
  • Fax:
Mailing address:
  • Phone: 949-509-0989
  • Fax: 949-679-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberG52658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: