Healthcare Provider Details

I. General information

NPI: 1326064775
Provider Name (Legal Business Name): DARRELL HAYES A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 30TH ST SUITE 400
OAKLAND CA
94609-3317
US

IV. Provider business mailing address

400 30TH ST SUITE 400
OAKLAND CA
94609-3317
US

V. Phone/Fax

Practice location:
  • Phone: 510-834-5484
  • Fax:
Mailing address:
  • Phone: 510-834-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG40458
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberG40458
License Number StateCA

VIII. Authorized Official

Name: DR. DARRELL WILLIAMS HAYES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 510-834-5484