Healthcare Provider Details

I. General information

NPI: 1902024813
Provider Name (Legal Business Name): CHRISTINA HILLSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE 4C070
SAN JOSE CA
95128-2604
US

IV. Provider business mailing address

751 S BASCOM AVE 4C070
SAN JOSE CA
95128-2604
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-5554
  • Fax: 408-885-5577
Mailing address:
  • Phone: 408-885-5554
  • Fax: 408-885-5577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD437809
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD437809
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: