Doctor Name: | GEORGE J HIESTER |
NPI Number: | 1285622704 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A16756 |
Business Practice Address: | 220 S Palisade Dr Suite 104b Santa Maria, CA - 934548902 |
Business Phone Number: | 8059252521 |
Business Fax Number: | 8059258721 |
Mailing Address: | 220 S Palisade Dr, Suite 104b SANTA MARIA |
State: | CA |
Postal Code: | 934548902 |
Phone Number: | 8059252521 |
Fax Number: | 8059258721 |
NPI Enumeration Date: | 10/10/2005 |
NPI Last Update Date: | 07/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A16756 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |