Basic Information
| Provider Information | |||||||||
| NPI: | 1265404719 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLMAN | ||||||||
| FirstName: | HERBERT | ||||||||
| MiddleName: | ARTHUR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 SUMMIT ST | ||||||||
| Address2: | FL 2 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108817822 | ||||||||
| FaxNumber: | 5108818552 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 SUMMIT ST | ||||||||
| Address2: | FL 2 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108698400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 03/16/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | C37361 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | 00C373610 | 05 | CA | MEDICAID |