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NPI Code Detail

MEDICARE: MATTHEW R HILEMAN, O D A PROFESIONAL CORPORATION

MEDICARE: MATTHEW R HILEMAN, O D A PROFESIONAL CORPORATION
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
1152W00000XOptometrist11888TCA

General Provider Information

NPI Number : 1457423501
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATTHEW R HILEMAN, O D A PROFESIONAL CORPORATION
Provider Business Mailing Address
First Line : 1104 ADAMS ST
Second Line : STE 101
City : SAINT HELENA
State : CA
Zip : 94574-1164
Country : US
Telephone Number : 707-963-7923
Fax Number :
Provider Business Practice Location Address
First Line : 1104 ADAMS ST
Second Line : STE 101
City : SAINT HELENA
State : CA
Zip : 94574-1164
Country : US
Telephone Number : 707-963-7923
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. MATTHEW HILEMAN
Credential : O.D.
Telephone Number : 707-963-7923
Provider Enumeration Date : 11/14/2006
Last Update Date : 05/16/2013

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Directions to “MATTHEW R HILEMAN, O D A PROFESIONAL CORPORATION ” Practice Location

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