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General NPI Number Information
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NPI Number | 1598061665
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Entity Type | Individual
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Provider Name | MONIQUE HALL PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 2755 HERNDON AVE
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City | CLOVIS
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State | CA
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Zip | 93611-6800
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Country | US
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Telephone | 559-970-0958
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Fax |
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Provider Business Mailing Address
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Address Line | 2755 HERNDON AVE
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City | CLOVIS
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State | CA
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Zip | 93611-6800
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Country | US
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Telephone | 559-970-0958
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 21518
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 112970
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10003672A
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License Number State | IN
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