Organization
HERTZOG EYE ASSOCIATES A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEIF HERTZOG MD (MD)
(562) 595-4366
Entity
Organization
Contact information
Practice address
5094 E LOS COYOTES DIAGONAL, LONG BEACH, CA 90815-2839
(562) 597-3100
(562) 597-5055
Mailing address
5094 E LOS COYOTES DIAGONAL, LONG BEACH, CA 90815-2839
(562) 597-3100
(562) 597-5055
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G52761
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W15323
GROUP
CA
Enumeration date
10/05/2007
Last updated
12/16/2015
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