Healthcare Provider Details

I. General information

NPI: 1497944110
Provider Name (Legal Business Name): MISS AMBER DAWN HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 OCEAN AVE
SAN FRANCISCO CA
94112-1727
US

IV. Provider business mailing address

2846 POLK ST
SAN FRANCISCO CA
94109-1014
US

V. Phone/Fax

Practice location:
  • Phone: 415-452-2200
  • Fax:
Mailing address:
  • Phone: 415-235-2442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: