Healthcare Provider Details
I. General information
NPI: 1477697563
Provider Name (Legal Business Name): HERMANN PETER LORENZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/20/2007
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
725 WELCH RD
PALO ALTO CA
94304-1601
US
IV. Provider business mailing address
725 WELCH RD
PALO ALTO CA
94304-1601
US
V. Phone/Fax
- Phone: 650-497-8000
- Fax:
- Phone: 650-497-8000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | G65307 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0122X |
| Taxonomy | Plastic and Reconstructive Surgery Physician |
| License Number | G65307 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | G65307 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: