Healthcare Provider Details

I. General information

NPI: 1245192103
Provider Name (Legal Business Name): PATRICK HILL RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 UCLA MEDICAL PLAZA
LOS ANGELES CA
90095-0001
US

IV. Provider business mailing address

1416 CARMONA AVE
LOS ANGELES CA
90019-3903
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-9179
  • Fax:
Mailing address:
  • Phone: 213-925-6102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95038149
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95108688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: