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General NPI Number Information
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NPI Number | 1417953043
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Entity Type | Individual
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Provider Name | SIDNEY MARK FISHMAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 40 OCEAN VISTA
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-705-8992
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Fax | 562-596-5703
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Provider Business Mailing Address
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Address Line | 40 OCEAN VISTA
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-705-8992
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Fax | 562-596-5703
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | AF7229455
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number | AF7229455
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | AF7229455
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License Number State | CA
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