MEDICARE: DR. STEPHEN E. HALL MD

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	2084P0805X	Geriatric Psychiatry Physician	G66949	CA
2	2084P0800X	Psychiatry Physician	G66949	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447298625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN E. HALL MD

Provider Business Mailing Address
First Line	:	PO BOX 12610
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-0610
Country	:	US
Telephone Number	:	415-469-2332
Fax Number	:	415-666-2335

Provider Business Practice Location Address
First Line	:	302 SILVER AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-1510
Country	:	US
Telephone Number	:	415-469-2332
Fax Number	:	415-666-2335

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	10/22/2019

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