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General NPI Number Information
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NPI Number | 1487976106
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Entity Type | Organization
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Legal Business Name | MARSHAL P FICHMAN MD A PROFESSIONAL CORP
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 8635 W 3RD ST SUITE 292W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-271-5784
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Fax | 310-289-8801
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Provider Business Mailing Address
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Address Line | 8635 W 3RD ST SUITE 292W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-271-5784
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Fax | 310-289-8801
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARSHAL P FICHMAN
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Credential | MD
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Telephone | 310-271-5784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A19736
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License Number State | CA
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