Individual
JAN ERIC HENSTORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
38690 STIVERS ST, FREMONT, CA 94536-5279
(510) 248-1040
(510) 797-7426
Mailing address
39141 CIVIC CENTER DR, SUITE 315, FREMONT, CA 94538-5818
(510) 248-1000
(510) 608-6055
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A448840
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
A448840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A448840
—
CA
Enumeration date
09/27/2005
Last updated
09/24/2014
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