Provider Demographics
NPI:1295821262
Name:WILLIAM F HERRMANN DPM PC
Entity Type:Organization
Organization Name:WILLIAM F HERRMANN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:HERRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:949-855-4634
Mailing Address - Street 1:PO BOX 11599
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-0599
Mailing Address - Country:US
Mailing Address - Phone:949-855-4634
Mailing Address - Fax:
Practice Address - Street 1:234 E 17TH ST
Practice Address - Street 2:SUITE #104
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3825
Practice Address - Country:US
Practice Address - Phone:949-855-4634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3248213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
480010316OtherRAILROAD MEDICARE
CAW22195Medicare PIN
480010316OtherRAILROAD MEDICARE