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General NPI Number Information
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NPI Number | 1598760373
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Entity Type | Individual
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Provider Name | MICHAEL ALAN HEISMAN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 175 N JACKSON AVE STE 200
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City | SAN JOSE
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State | CA
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Zip | 95116-1909
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Country | US
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Telephone | 408-384-7160
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Fax |
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Provider Business Mailing Address
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Address Line | 175 N JACKSON AVE STE 200
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City | SAN JOSE
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State | CA
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Zip | 95116-1909
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Country | US
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Telephone |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E02316
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License Number State | CA
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