Provider Demographics
NPI:1407893621
Name:HIRSHLEIFER, JOHN ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ALFRED
Last Name:HIRSHLEIFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 BROADWAY
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1837
Mailing Address - Country:US
Mailing Address - Phone:510-662-5894
Mailing Address - Fax:
Practice Address - Street 1:1221 BROADWAY
Practice Address - Street 2:3RD FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1837
Practice Address - Country:US
Practice Address - Phone:510-662-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32352207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine