MEDICARE: DR. ALBERT W HAWKINS MD

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	207R00000X	Internal Medicine Physician	C41368	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588664478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT W HAWKINS MD

Provider Business Mailing Address
First Line	:	1300 E CYPRESS ST
Second Line	:	G1
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-4728
Country	:	US
Telephone Number	:	805-928-0997
Fax Number	:	805-928-1147

Provider Business Practice Location Address
First Line	:	1300 E CYPRESS ST
Second Line	:	G1
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-4728
Country	:	US
Telephone Number	:	805-928-0997
Fax Number	:	805-928-1147

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	02/01/2017

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