Healthcare Provider Details

I. General information

NPI: 1447298625
Provider Name (Legal Business Name): STEPHEN E. HALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 SILVER AVE
SAN FRANCISCO CA
94112-1510
US

IV. Provider business mailing address

PO BOX 12610
SAN FRANCISCO CA
94112-0610
US

V. Phone/Fax

Practice location:
  • Phone: 415-469-2332
  • Fax: 415-666-2335
Mailing address:
  • Phone: 415-469-2332
  • Fax: 415-666-2335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberG66949
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG66949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: