Healthcare Provider Details

I. General information

NPI: 1942292404
Provider Name (Legal Business Name): DAVID A. HILL P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 N INDIAN CANYON DR SUITE W201
PALM SPRINGS CA
92262-4402
US

IV. Provider business mailing address

1180 N INDIAN CANYON DRIVE SUITE W201
PALM SPRINGS CA
92262-4402
US

V. Phone/Fax

Practice location:
  • Phone: 760-416-4511
  • Fax: 760-416-4512
Mailing address:
  • Phone: 760-416-4511
  • Fax: 760-416-4512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA13107
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA13107
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA13107
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: