Provider Demographics
NPI:1457570889
Name:HIRSCHENBEIN, NEIL W (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:W
Last Name:HIRSCHENBEIN
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9339 GENESEE AVE
Mailing Address - Street 2:SUITE#150
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2119
Mailing Address - Country:US
Mailing Address - Phone:858-546-8055
Mailing Address - Fax:858-546-8281
Practice Address - Street 1:9339 GENESEE AVE
Practice Address - Street 2:SUITE#150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2119
Practice Address - Country:US
Practice Address - Phone:858-546-8055
Practice Address - Fax:858-546-8281
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine