Herron, George

Herron, George is an individual health care provider with primary practice located at 1610 N El Dorado St Suite 17, Stockton CA 95204-5930. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Herron, George can be contacted via phone (209) 465-5107.

Contact Information

Primary practice address
1610 N El Dorado St Suite 17 Stockton CA 95204-5930
Phone: (209) 465-5107
Fax: (209) 465-7653
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G10082 California
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X G10082 California

Profile Details

NPI number 1144217654
LBN Legal business name Herron, George
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated May 30th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144217654 NPPES
California MEDICAID 00G100820

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