Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | C42263 | CA |
NPI | 1124168471 |
---|---|
Provider Name | Dr. William Mitchell Heroman |
First Address | San Diego, CA 92130-1324 |
Second Address | San Diego, CA 92134-1098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 09/11/2007 |