| Robert Jeffrey Herten, MD | |
|
15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | |
| (805) 541-2650 | |
| (805) 541-4043 |
| Full Name | Robert Jeffrey Herten |
|---|---|
| Gender | Male |
| Speciality | Dermatology - Dermatopathology |
| Location | 15 Santa Rosa St, San Luis Obispo, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265407852 | NPI | - | NPPES |
| 00A253070 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ND0900X | Dermatology - Dermatopathology | A25307 (California) | Primary |
| Entity Name | San Luis Dermatology & Laser Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568431500 PECOS PAC ID: 5496700767 Enrollment ID: O20050318000855 |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Jeffrey Herten, MD 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 Ph: (805) 541-2650 | Robert Jeffrey Herten, MD 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 Ph: (805) 541-2650 |
Dr. Shirley Lynne Van, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 862 Aerovista Pl Ste 100, San Luis Obispo, CA 93401 Phone: 805-549-8023 Fax: 805-549-8252 | |
Lisa Lindvall Aquino, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 990 Pacific St, San Luis Obispo, CA 93401 Phone: 805-544-5567 Fax: 805-544-5567 | |
Christine Denise Kilcline, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 892 Aerovista Pl Ste 120, San Luis Obispo, CA 93401 Phone: 805-544-5567 Fax: 805-544-3265 | |
Ronnie M Abraham, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3440 Empresa Dr Ste B, San Luis Obispo, CA 93401 Phone: 805-548-1550 Fax: 805-623-1595 | |
John Barry Siebenlist, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1551 Bishop St, Suite 220, San Luis Obispo, CA 93401 Phone: 805-541-0668 Fax: 805-541-8213 | |
Charles B. Fishman, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1551 Bishop St, Suite 410, San Luis Obispo, CA 93401 Phone: 805-541-4180 Fax: 805-541-2542 |