=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962500470
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RALPH G HESLER, II, M.D., INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 11/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3927 WARING RD SUITE A
-----------------------------------------------------
City | OCEANSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92056-4458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-758-7100
-----------------------------------------------------
Fax | 760-758-7105
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3927 WARING RD SUITE A
-----------------------------------------------------
City | OCEANSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92056-4458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-758-7100
-----------------------------------------------------
Fax | 760-758-7105
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RALPH GALEN HESLER II
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 760-758-7100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | A24475
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------