Healthcare Provider Details

I. General information

NPI: 1851472161
Provider Name (Legal Business Name): MARTHA S HALES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1783 EL CAMINO REAL HOSPITAL PATHOLOGY DEPT
BURLINGAME CA
94010-3205
US

IV. Provider business mailing address

PO BOX 281560
SAN FRANCISCO CA
94128-1560
US

V. Phone/Fax

Practice location:
  • Phone: 650-696-5611
  • Fax:
Mailing address:
  • Phone: 650-616-2948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberG44502
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG44502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: