Individual
DR. BRUCE DAVID HERZOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3555 CLARES ST STE H, CAPITOLA, CA 95010-2539
(831) 477-4900
(831) 477-4909
Mailing address
3555 CLARES ST STE H, CAPITOLA, CA 95010-2539
(831) 477-4900
(831) 477-4909
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT8087
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086942
—
IA
01
—
410014677
RAILROAD MEDICARE
—
01
—
910904
EYEMED
—
Enumeration date
09/23/2006
Last updated
02/18/2016
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