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General NPI Number Information
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NPI Number | 1023309622
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Entity Type | Individual
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Provider Name | MICHAEL HIPOLITO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 450 SUTTER ST SUITE 1728
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4206
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Country | US
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Telephone | 415-347-8580
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Fax | 415-528-7034
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Provider Business Mailing Address
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Address Line | 450 SUTTER ST SUITE 1728
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4206
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Country | US
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Telephone | 415-347-8580
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Fax | 415-528-7034
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A122007
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License Number State | CA
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