DR. MICHAEL P HEFFERNAN (NPI# 1518923432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518923432 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL P HEFFERNAN |
| Credential | MD |
| Practice Address |
15 Santa Rosa St San Luis Obispo CA 93405-1811 |
| Practice Telephone | 8055412650 |
| Practice Fax Number | 8055414043 |
| Mailing Telephone | 8055412650 |
| Mailing Fax Number | 8055414043 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2014-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | G80065 | CA | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 01072447A | IN | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 35074557 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2601929 | 05 | |
| IN | 201183400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457349920 | Michael Heffernan | Psychologist | 408 N Third Street, Fulton, TX 78358 | 2005-10-10 |
| 1326675802 | Michael Heffernan | Physician Assistant | 278 Eagleview Blvd, Exton, PA 19341-1157 | 2020-03-25 |
| 1326359506 | Michael Adam Heffernan | Physical Therapist | 2032 New Castle Ave, New Castle, DE 19720-7703 | 2010-06-23 |
| 1750588836 | Michael Heffernan | Orthopaedic Surgery | 200 Henry Clay Ave, New Orleans, LA 70118-5720 | 2007-07-02 |
| 1588738603 | Michael Heffernan | Counselor | 345 Blackstone Blvd, Providence, RI 02906-4800 | 2006-11-20 |
| Street Address |
15 SANTA ROSA ST |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93405-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265407852 | Robert Jeffrey Herten | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-02-17 |
| 1770938532 | Cheryl Ketelsen | Physician Assistant | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2016-04-29 |
| 1265616361 | Jennifer Remington | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2007-12-26 |
| 1568431500 | San Luis Dermatology & Laser Clinic Inc | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164076626 | Hilary Abbott Anderson | Physician Assistant | 127 Casa St., San Luis Obispo, CA 93405 | 2019-08-01 |
| 1811465834 | Fatemeh Ladan Ahmadinia | Dentist | 764 N Santa Rosa St, San Luis Obispo, CA 93405 | 2018-11-07 |
| 1538559794 | Arnold Martin Horwitz | Marriage & Family Therapist | 1605 Garnette Drive, San Luis Obispo, CA 93405 | 2015-01-27 |
| 1750794764 | Solmaz Naghsh | Pharmacist | 765 Foothill Blvd, San Luis Obispo, CA 93405 | 2014-06-06 |
| 1609293471 | Robert S. Flores Dmd, Inc | Dentist | 878 Boysen Avenue, San Luis Obispo, CA 93405 | 2014-03-18 |
| 1457776445 | Laura Anne Wilvert | Marriage & Family Therapist | 793 E. Foothill Blvd, Suite A, #278, San Luis Obispo, CA 93405 | 2014-02-27 |
| 1497181200 | Tracey Ruby Madrigal | Counselor | 1106 Oceanaire Dr. #25, San Luis Obispo, CA 93405 | 2013-09-25 |
| 1437597572 | Sarah Michelle Brenis | Counselor | 524 Princeton Place, San Luis Obispo, CA 93405 | 2013-06-11 |
| 1013350974 | Jenna Rose Ramos | Counselor | 1459 Descanso St., San Luis Obispo, CA 93405 | 2013-04-10 |
| 1700140696 | Christopher Dieterich Marchand | Social Worker | 793a E. Foothill Blvd, 190, San Luis Obispo, CA 93405 | 2012-06-26 |
| Find all providers in zip 93405 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200183 | Karen Denise Allen | Dermatology | 715 Tank Farm Rd, San Luis Obispo, CA 93401-7068 | 2005-07-29 |
| 1063781557 | Lisa Lindvall Aquino | Dermatology | 990 Pacific St, San Luis Obispo, CA 93401-6309 | 2011-12-29 |
| 1588985113 | Laura Frances Sandoval | Dermatology | 805 Aerovista Pl Ste 202, San Luis Obispo, CA 93401-7920 | 2010-06-17 |
| 1508199431 | Blanca Bisuna | Dermatology | 1250 Peach Street, Suite A, San Luis Obispo, CA 93401-2837 | 2009-09-10 |
| 1265616361 | Jennifer Remington | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2007-12-26 |
| 1255528113 | Charles B. Fishman, M.d., A Professional Corporation | Dermatology | 1551 Bishop St, Suite 410, San Luis Obispo, CA 93401-4635 | 2007-09-25 |
| 1437361771 | Paul Stephen Collins | Dermatology | 84 Santa Rosa St, San Luis Obispo, CA 93405-1812 | 2007-05-07 |
| 1730279944 | R Jeffrey Herten Md Inc | Dermatology | 15 Santa Rosa Street, San Luis Obispo, CA 93405-1811 | 2006-10-16 |
| 1194825752 | Charles B. Fishman | Dermatology | 1551 Bishop St, Suite 410, San Luis Obispo, CA 93401-4635 | 2006-09-24 |
| 1568431500 | San Luis Dermatology & Laser Clinic Inc | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-03-14 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93405 |
Please comment or provide details below to improve the information on DR. MICHAEL P HEFFERNAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.