Provider Demographics
NPI:1699898288
Name:PAUL W. HERRMANN, M.D., INC.
Entity type:Organization
Organization Name:PAUL W. HERRMANN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-492-0928
Mailing Address - Street 1:140 OAK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3839
Mailing Address - Country:US
Mailing Address - Phone:415-492-0928
Mailing Address - Fax:415-492-1610
Practice Address - Street 1:140 OAK VIEW DR
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3839
Practice Address - Country:US
Practice Address - Phone:415-492-0928
Practice Address - Fax:415-492-1610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC32859207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic PathologyGroup - Single Specialty