Healthcare Provider Details

I. General information

NPI: 1154485431
Provider Name (Legal Business Name): DAVID FISHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLMONT AVE
VENTURA CA
93003-1651
US

IV. Provider business mailing address

3418 LOMA VISTA RD SUITE A
VENTURA CA
93003
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6000
  • Fax:
Mailing address:
  • Phone: 805-642-8565
  • Fax: 805-642-8564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG45277
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG45277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: