Provider Demographics
NPI:1851472161
Name:HALES, MARTHA S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:S
Last Name:HALES
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:PO BOX 281560
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94128-1560
Mailing Address - Country:US
Mailing Address - Phone:650-616-2948
Mailing Address - Fax:
Practice Address - Street 1:1783 EL CAMINO REAL
Practice Address - Street 2:HOSPITAL PATHOLOGY DEPT
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3205
Practice Address - Country:US
Practice Address - Phone:650-696-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG44502207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G445021Medicaid
CAG44502OtherMEDICAL BOARD LICENSE
CA00G445021Medicare PIN
CAG44502OtherMEDICAL BOARD LICENSE