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Individual

DR. JOHN CHATFIELD HISERODT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7707 GARDEN GROVE BLVD, GARDEN GROVE, CA 92841-4207
(714) 902-1762
(657) 400-9073
Mailing address
7707 GARDEN GROVE BLVD, GARDEN GROVE, CA 92841-4207
(714) 902-1762
(657) 400-9073

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
G77372
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G773720
CA
01
G77372
CALIFORNIA MEDICAL LICENS
CA
Enumeration date
01/02/2007
Last updated
03/13/2019
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