Organization
GEORGE R HERRON JR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE HERRON M.D., (CHIEF EXECUTIVE OFFICER)
(209) 465-5107
Entity
Organization
Contact information
Practice address
1610 N EL DORADO ST STE 17, STOCKTON, CA 95204-5930
(209) 465-5107
Mailing address
1610 N EL DORADO ST STE 17, STOCKTON, CA 95204-5930
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G100820
—
CA
Enumeration date
10/23/2006
Last updated
02/02/2009
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