Healthcare Provider Details

I. General information

NPI: 1245499060
Provider Name (Legal Business Name): DANIEL C HERMAN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 10/28/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 C ST STE 1600
SACRAMENTO CA
95816-3384
US

IV. Provider business mailing address

4860 Y ST. STE 3850 DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION
SACRAMENTO CA
95817-0001
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-6805
  • Fax:
Mailing address:
  • Phone: 916-734-7041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME116759
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number174837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: