Provider Demographics
NPI:1093861569
Name:HERGAN, LORI ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ANN
Last Name:HERGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1225 E LATHAM AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4423
Mailing Address - Country:US
Mailing Address - Phone:951-929-2800
Mailing Address - Fax:951-929-2303
Practice Address - Street 1:1225 E LATHAM AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4423
Practice Address - Country:US
Practice Address - Phone:951-929-2800
Practice Address - Fax:951-929-2800
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA86666208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology