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General NPI Number Information
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NPI Number | 1245739283
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Entity Type | Individual
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Provider Name | GEORGE HOWARD HERZOG RN, CNS
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Gender | Male
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 02/05/2018
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Provider Practice Location Address
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Address Line | 4150 CLEMENT ST G1-111B1
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City | SAN FRANCISCO
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State | CA
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Zip | 94121
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Country | US
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Telephone | 415-221-4810
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Fax |
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Provider Business Mailing Address
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Address Line | 88 PALISADES DR
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City | DALY CITY
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State | CA
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Zip | 94015-4511
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Country | US
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Telephone | 415-516-9852
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | 4606
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 4606
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License Number State | CA
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