Provider Demographics
NPI:1578107686
Name:WILLIAM J HERINGER MD A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:WILLIAM J HERINGER MD A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:COMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-688-7200
Mailing Address - Street 1:2030 VIBORG RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-3226
Mailing Address - Country:US
Mailing Address - Phone:805-688-7200
Mailing Address - Fax:805-688-2894
Practice Address - Street 1:2030 VIBORG RD STE 201
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3226
Practice Address - Country:US
Practice Address - Phone:805-688-7200
Practice Address - Fax:805-688-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care