Provider Demographics
NPI:1063497097
Name:HILL, HANK C (MD)
Entity Type:Individual
Prefix:
First Name:HANK
Middle Name:C
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:516 WEST ATEN ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-9805
Mailing Address - Country:US
Mailing Address - Phone:760-355-7730
Mailing Address - Fax:904-296-5871
Practice Address - Street 1:1665 SOUTH IMPERIAL AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243
Practice Address - Country:US
Practice Address - Phone:760-312-5999
Practice Address - Fax:760-355-9522
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2020-09-15
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Provider Licenses
StateLicense IDTaxonomies
GUM-2070208600000X, 2086X0206X
GUMTL-2017-081208600000X, 2086X0206X
FLME1085792086X0206X
CAC1594182086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002974700Medicaid
FL14A5QOtherBCBS
FL341772OtherAVMED
CAW13536OtherMEDICARE
FLP988384OtherFREEDOM HEALTH
GA003104080AMedicaid
FLP932535OtherOPTIMUM
CA1063497097Medicaid
FL1708116OtherCIGNA
FL581887OtherWELLCARE
FL7135401OtherAETNA
FLP00889561OtherRAILROAD MEDICARE