Individual
DR. CHARLES E HERGESHEIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G76058
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G760580
—
CA
01
—
110180440
RAILROAD MEDICARE
CA
01
—
2598496
GHI
CA
Enumeration date
06/25/2006
Last updated
06/02/2021
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