Individual
IGOR IMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 OWENS ST, CAMPUS BOX 3004, SAN FRANCISCO, CA 94158-2334
(415) 353-7584
(415) 353-7200
Mailing address
1500 OWENS ST, CAMPUS BOX 3004, SAN FRANCISCO, CA 94158-2334
(415) 353-7584
(415) 353-7200
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
A119472
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A119472
MEDICAL LICENSE
CA
01
—
P01412212
RAILROAD MEDICARE
CA
Enumeration date
07/14/2008
Last updated
11/03/2016
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