Individual
GREGORY THOMAS HEINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301W HUNTINGTON DR 617, ARCADIA, CA 91007-1518
(626) 574-9745
(626) 574-8741
Mailing address
301W HUNTINGTON DR 617, ARCADIA, CA 91007-1518
(626) 574-9745
(626) 574-8741
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G081061
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
G81061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ75817Z
—
CA
Enumeration date
06/17/2006
Last updated
06/27/2024
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