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Individual

LEONARD Y HERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
250 S GRAND AVE, GLENDORA, CA 91741-4218
(626) 840-5655
(626) 287-1940
Mailing address
PO BOX 661688, ARCADIA, CA 91066-1688
(626) 840-5655
(626) 287-1940

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G85589
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G855890
BLUE SHIELD
CA
05
00G855890
CA
Enumeration date
06/02/2006
Last updated
06/06/2009
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