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General NPI Number Information
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NPI Number | 1912936766
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Entity Type | Organization
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Legal Business Name | HERMANSON MEDICAL GROUP A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 300 CANAL STREET
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City | KING CITY
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State | CA
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Zip | 93930-3431
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Country | US
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Telephone | 831-385-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11300
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City | WESTMINSTER
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State | CA
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Zip | 92685-1300
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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 | PRESIDENT
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Name | CHRISTOPHER G HERMANSON
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Credential | MD
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Telephone | 831-385-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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