MEDICARE: GREGG E HILL PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA19966	CA

General Provider Information

NPI Number	:	1124359195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGG E HILL PAC

Provider Business Mailing Address
First Line	:	26700 TOWNE CENTRE DR STE 100
Second Line	:
City	:	FOOTHILL RANCH
State	:	CA
Zip	:	92610-2843
Country	:	US
Telephone Number	:	949-460-9111
Fax Number	:	949-460-9055

Provider Business Practice Location Address
First Line	:	26700 TOWNE CENTRE DR STE 100
Second Line	:
City	:	FOOTHILL RANCH
State	:	CA
Zip	:	92610-2843
Country	:	US
Telephone Number	:	949-460-9111
Fax Number	:	949-460-9055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	01/14/2010

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Directions to “ GREGG E HILL PAC” Practice Location

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