Individual
GEORGE HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1610 N EL DORADO ST, SUITE 17, STOCKTON, CA 95204-5930
(209) 465-5107
(209) 465-7653
Mailing address
1610 N EL DORADO ST, SUITE 17, STOCKTON, CA 95204-5930
(209) 465-5107
(209) 465-7653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G10082
CA
207RN0300X
Nephrology Physician
Primary
G10082
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G100820
—
CA
Enumeration date
09/29/2005
Last updated
05/30/2008
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