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General NPI Number Information
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NPI Number | 1679011035
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Entity Type | Organization
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Legal Business Name | HILL PHYSICIANS MEDICAL GROUP - PPO PROGRAM
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 2409 CAMINO RAMON
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City | SAN RAMON
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State | CA
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Zip | 94583-4285
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Country | US
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Telephone | 925-820-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 2409 CAMINO RAMON
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City | SAN RAMON
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State | CA
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Zip | 94583-4285
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Country | US
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Telephone | 925-820-8300
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. TIMOTHY RICHARDS
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Credential |
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Telephone | 925-327-6735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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