Healthcare Provider Details

I. General information

NPI: 1538630165
Provider Name (Legal Business Name): ALEXANDER PHILLIP HAWLEY I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 NEVIN AVE
RICHMOND CA
94801-3143
US

IV. Provider business mailing address

1501 DETROIT AVE APT 33
CONCORD CA
94520-3318
US

V. Phone/Fax

Practice location:
  • Phone: 510-307-3055
  • Fax:
Mailing address:
  • Phone: 509-793-8876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2278P1006X
TaxonomyPulmonary Function Technologist Certified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number141815
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: