Individual
CHARLES B. FISHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1551 BISHOP ST, SUITE 410, SAN LUIS OBISPO, CA 93401-4635
(805) 541-4180
(805) 541-2542
Mailing address
1551 BISHOP ST, SUITE 410, SAN LUIS OBISPO, CA 93401-4635
(805) 541-4180
(805) 541-2542
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
C 31365
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W18438
MEDICARE GROUP #
CA
01
—
WC31365A
PPIN #
CA
Enumeration date
09/24/2006
Last updated
07/08/2007
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