=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356536262
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MALCOLM D. HILL, M.D., INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2007
-----------------------------------------------------
Last Update Date | 02/04/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1826 SONOMA ST
-----------------------------------------------------
City | REDDING
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96001-2535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-244-6500
-----------------------------------------------------
Fax | 530-244-7826
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 496084
-----------------------------------------------------
City | REDDING
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96049-6084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-241-0473
-----------------------------------------------------
Fax | 530-241-5377
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MALCOLM D. HILL
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 530-244-6500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | G25286
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------