Provider Demographics
NPI:1538281324
Name:HILL, STEPHEN JON (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JON
Last Name:HILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 2ND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024
Mailing Address - Country:US
Mailing Address - Phone:760-632-7778
Mailing Address - Fax:760-632-0429
Practice Address - Street 1:1020 2ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024
Practice Address - Country:US
Practice Address - Phone:760-632-7778
Practice Address - Fax:760-632-0429
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACADC15469111N00000X
CADC15469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1538281324OtherMEDICARE LEGACY IDENTIFIER
CA1538281324Medicare PIN
CA1538281324Medicare UPIN
CA1538281324OtherMEDICARE LEGACY IDENTIFIER