| Doctor Name: | DR. JOSEPH CHARLES HEFFERNAN |
| NPI Number: | 1871669507 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | G24420 |
| Business Practice Address: | 2628 El Camino Avenue Suite A 8 Sacramento, CA - 958215934 |
| Business Phone Number: | 9164861311 |
| Business Fax Number: | 9164861312 |
| Mailing Address: | 2628 El Camino Avenue, Suite A 8 SACRAMENTO |
| State: | CA |
| Postal Code: | 958215934 |
| Phone Number: | 9164861311 |
| Fax Number: | 9164861312 |
| NPI Enumeration Date: | 11/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G24420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |