Provider Demographics
NPI:1235690348
Name:HILVERS, TAMARA RACHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:RACHELLE
Last Name:HILVERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-3606
Mailing Address - Country:US
Mailing Address - Phone:661-765-1935
Mailing Address - Fax:661-765-1928
Practice Address - Street 1:100 E NORTH ST
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3606
Practice Address - Country:US
Practice Address - Phone:661-765-1935
Practice Address - Fax:661-765-1928
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTL1771390200000X
CAA180470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program