Healthcare Provider Details

I. General information

NPI: 1861424830
Provider Name (Legal Business Name): NEIL J SHERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 S SUNSET AVE #301
WEST COVINA CA
91790
US

IV. Provider business mailing address

1135 S SUNSET AVE #301
WEST COVINA CA
91790
US

V. Phone/Fax

Practice location:
  • Phone: 626-338-5563
  • Fax: 626-814-0654
Mailing address:
  • Phone: 626-338-5563
  • Fax: 626-814-0654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberC31022
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: