Healthcare Provider Details

I. General information

NPI: 1124190202
Provider Name (Legal Business Name): HECTOR C STREETER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

V. Phone/Fax

Practice location:
  • Phone: 415-925-7591
  • Fax: 415-925-7604
Mailing address:
  • Phone: 415-925-7591
  • Fax: 415-925-7604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number21763
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberC50184
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: