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General NPI Number Information
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NPI Number | 1861988834
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Entity Type | Organization
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Legal Business Name | JOHN R HERALD MD INC
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1804
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Country | US
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Telephone | 310-933-9616
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Fax | 661-878-8551
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Provider Business Mailing Address
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Address Line | PO BOX 2552
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City | BEVERLY HILLS
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State | CA
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Zip | 90213-2552
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Country | US
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Telephone | 310-933-9616
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Fax | 661-878-8551
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | JOHN R HERALD
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Credential | MD
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Telephone | 310-786-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A148177
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A148177
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License Number State | CA
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