Provider Demographics
NPI:1619991635
Name:HILL, JAMES DANIEL JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DANIEL
Last Name:HILL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WEBSTER ST
Mailing Address - Street 2:SUITE 404-410
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3117
Mailing Address - Country:US
Mailing Address - Phone:510-549-4220
Mailing Address - Fax:510-433-0744
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:SUITE 404-410
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3117
Practice Address - Country:US
Practice Address - Phone:510-549-4220
Practice Address - Fax:510-433-0744
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22346207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G223460Medicaid
CA00A89360Medicare UPIN
CA00G223460Medicare ID - Type Unspecified