Provider Demographics
NPI:1023198181
Name:HERMANOWICZ, NEAL (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:HERMANOWICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:520 SUPERIOR AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3667
Mailing Address - Country:US
Mailing Address - Phone:949-764-7363
Mailing Address - Fax:760-837-8784
Practice Address - Street 1:520 SUPERIOR AVE STE 205
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3667
Practice Address - Country:US
Practice Address - Phone:949-764-7363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG840772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG84077AMedicare PIN