Healthcare Provider Details

I. General information

NPI: 1932138427
Provider Name (Legal Business Name): RONALD ALAN HULL D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20642 JOHN DR
CASTRO VALLEY CA
94546-5103
US

IV. Provider business mailing address

20642 JOHN DR
CASTRO VALLEY CA
94546-5103
US

V. Phone/Fax

Practice location:
  • Phone: 510-581-2559
  • Fax: 510-581-5396
Mailing address:
  • Phone: 510-581-2559
  • Fax: 510-581-5396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE3498
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number3498
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number3498
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: