Healthcare Provider Details

I. General information

NPI: 1720071327
Provider Name (Legal Business Name): FRANK W HULL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 PENNSYLVANIA AVE STE B
FAIRFIELD CA
94533
US

IV. Provider business mailing address

1710 PENNSYLVANIA AVE STE B
FAIRFIELD CA
94533
US

V. Phone/Fax

Practice location:
  • Phone: 707-422-6500
  • Fax: 707-422-6556
Mailing address:
  • Phone: 707-422-6500
  • Fax: 707-422-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC279520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: