Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A137295 | CA |
NPI | 1164833406 |
---|---|
Provider Name | Dr. Nathanael David Heckmann |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2014 |
Last Update Date | 07/09/2020 |