Provider Demographics
NPI:1033294228
Name:HAND, TERRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:HAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S ELISEO DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2134
Mailing Address - Country:US
Mailing Address - Phone:415-461-6742
Mailing Address - Fax:415-461-6782
Practice Address - Street 1:900 S ELISEO DR
Practice Address - Street 2:SUITE 103
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2134
Practice Address - Country:US
Practice Address - Phone:415-461-6742
Practice Address - Fax:415-461-6782
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20662261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG20662OtherCA LICENSE
CAA41010Medicare UPIN