Provider Demographics
NPI:1699842260
Name:HILLTOP FAMILY MEDICAL GROUP INC
Entity Type:Organization
Organization Name:HILLTOP FAMILY MEDICAL GROUP INC
Other - Org Name:DANIEL A JARDINI MD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JARDINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-424-5784
Mailing Address - Street 1:130 E ROMIE LANE
Mailing Address - Street 2:SUITE D
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901
Mailing Address - Country:US
Mailing Address - Phone:831-424-5784
Mailing Address - Fax:831-424-1219
Practice Address - Street 1:130 E ROMIE LANE
Practice Address - Street 2:SUITE D
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-424-5784
Practice Address - Fax:831-424-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A53102Medicare UPIN
CAZZZ3403ZMedicare ID - Type Unspecified