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General NPI Number Information
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NPI Number | 1518444199
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Entity Type | Individual
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Provider Name | STEPHEN HARE PTA
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Gender | Male
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 321 MIDDLEFIELD RD
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City | MENLO PARK
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State | CA
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Zip | 94025-3500
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Country | US
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Telephone | 650-497-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7132
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City | CARMEL
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State | CA
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Zip | 93921-7132
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Country | US
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Telephone |
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1941
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License Number State | CA
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