Healthcare Provider Details

I. General information

NPI: 1588819833
Provider Name (Legal Business Name): CHRISTOPHER WILLIAM HERMAN C.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2008
Last Update Date: 11/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1545
US

IV. Provider business mailing address

4150 CLEMENT ST
SAN FRANCISCO CA
94121-1545
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax: 415-750-6991
Mailing address:
  • Phone: 415-221-4810
  • Fax: 415-750-6991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCP1090
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: