Heffernan, Michael P

Heffernan, Michael P is an individual health care provider with primary practice located at 15 Santa Rosa St , San Luis Obispo CA 93405-1811. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Heffernan, Michael P can be contacted via phone (805) 541-2650.

Contact Information

Primary practice address
15 Santa Rosa St San Luis Obispo CA 93405-1811
Phone: (805) 541-2650
Fax: (805) 541-4043
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 35074557 Ohio
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 01072447A Indiana
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G80065 California

Profile Details

NPI number 1518923432
LBN Legal business name Heffernan, Michael P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Oct 13th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518923432 NPPES
Indiana MEDICAID 201183400
Indiana MEDICAID 2601929

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