MEDICARE: PETER HAWKINS M.D., PH.D.

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	2085R0001X	Radiation Oncology Physician	A161883	CA

General Provider Information

NPI Number	:	1962820621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER HAWKINS M.D., PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 756
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-0756
Country	:	US
Telephone Number	:	877-866-0914
Fax Number	:	209-343-3809

Provider Business Practice Location Address
First Line	:	301 PROFESSIONAL CENTER DR
Second Line	:
City	:	ROHNERT PARK
State	:	CA
Zip	:	94928-2152
Country	:	US
Telephone Number	:	707-584-2200
Fax Number	:	707-584-7582

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

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	07/19/2023

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