MEDICARE: DAVE HILL JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver

General Provider Information

NPI Number	:	1407030869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVE HILL JR.

Provider Business Mailing Address
First Line	:	2433 BROWNING ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94702-2026
Country	:	US
Telephone Number	:	510-967-8723
Fax Number	:

Provider Business Practice Location Address
First Line	:	418 PENDLETON WAY
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94621-2116
Country	:	US
Telephone Number	:	510-967-8723
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	12/20/2007

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Directions to “ DAVE HILL JR. ” Practice Location

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