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General NPI Number Information
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NPI Number | 1124668660
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Entity Type | Organization
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Legal Business Name | DISCOVER HEALTH MEDICAL GROUP 2, INC.
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 990 COLUMBUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94133-2310
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Country | US
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Telephone | 707-255-8825
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Fax | 707-252-9325
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Provider Business Mailing Address
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Address Line | 3010 BEARD RD
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City | NAPA
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State | CA
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Zip | 94558-3442
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Country | US
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Telephone | 707-255-8825
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Fax | 707-252-9325
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ODED HERBSMAN
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Credential | MD
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Telephone | 707-255-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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