Hertzog Eye Associates a Medical Corporation

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G52761 Issued in CA

Legal business name

HERTZOG EYE ASSOCIATES A MEDICAL CORPORATION

Practice address

5094 E Los Coyotes Diagonal
Long Beach, CA 90815-2839

Phone

(562) 597-3100

Fax

(562) 597-5055

NPI assigned

Oct 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leif Hertzog, MDNPI 1528139367

Title

MD

Phone

(562) 595-4366

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leif M Hertzog, MD

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1528139367
  Medicare reassignment NPD Authorized official
• Jennifer Lee, O.D.

  • Optometrist
  • Long Beach, CA
  • NPI 1891147351
  Medicare reassignment Care Compare group NPD
• Hans Dieter Hertzog, M.D.

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1851616064
  Medicare reassignment Care Compare group
• Hamideh Sadat Moayedpardazi

  • Ophthalmology Physician
  • Montebello, CA
  • NPI 1386933240
  Care Compare group
• Lars H Hertzog, M.D., F.A.C.S.

  • Ophthalmology Physician
  • Long Beach, CA
  • NPI 1629164454
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1619165446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5094 E LOS COYOTES DIAGONAL",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908152839",
            "telephone_number": "562-597-3100",
            "fax_number": "562-597-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5094 E LOS COYOTES DIAGONAL",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908152839",
            "telephone_number": "562-597-3100",
            "fax_number": "562-597-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERTZOG EYE ASSOCIATES A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "HERTZOG",
        "authorized_official_first_name": "LEIF",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "562-595-4366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G52761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "W15323",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lizette Herrera, LMFT
• Patricia Herridge
• Grace Herron
• Kathleen Ann Herron, M.D.
• Melvin Herst, M.A.
• Hertzog Optical, LLC
• Hans Dieter Hertzog, M.D.
• Lars H Hertzog, M.D., F.A.C.S.
• Leif M Hertzog, MD
• Cynthia Herzog, M.D.

• Ophthalmology Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.