Provider Demographics
NPI:1588600753
Name:HERMAN, MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:HERMAN
Suffix:
Gender:F
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:DEPT 34929
Mailing Address - Street 2:P.O. BOX 39000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-0001
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:140 BROOKWOOD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-3042
Practice Address - Country:US
Practice Address - Phone:925-254-9090
Practice Address - Fax:925-254-4399
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54190207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G541900Medicaid
CAF44882Medicare UPIN
CA00G541903Medicare PIN