Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A49510 | CA |
NPI | 1235174822 |
---|---|
Provider Name | Dr. Herman L Hedriana |
First Address | Sacramento, CA 95817-2307 |
Second Address | Sacramento, CA 95817-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 18/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A495100 | (05) | CA |
E7579 | (02) | CA |