Provider Demographics
NPI:1508981721
Name:HILLIER, CARL GEORGE (OD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:GEORGE
Last Name:HILLIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7898 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945
Mailing Address - Country:US
Mailing Address - Phone:619-464-7713
Mailing Address - Fax:619-464-7668
Practice Address - Street 1:7898 BROADWAY
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945
Practice Address - Country:US
Practice Address - Phone:619-464-7713
Practice Address - Fax:619-464-7668
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT7706T152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
T70219Medicare UPIN