Provider Demographics
NPI:1164751541
Name:DENNIS R HILL MD PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DENNIS R HILL MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-869-8875
Mailing Address - Street 1:3012 SUMMIT ST # 2675
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3480
Mailing Address - Country:US
Mailing Address - Phone:510-869-8875
Mailing Address - Fax:510-869-8882
Practice Address - Street 1:3012 SUMMIT ST # 2675
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3480
Practice Address - Country:US
Practice Address - Phone:510-869-8875
Practice Address - Fax:510-869-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG172252085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40022Medicare UPIN