Provider Demographics
NPI:1891190385
Name:HYZY, MARGARET ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANNE
Last Name:HYZY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARNIE
Other - Middle Name:
Other - Last Name:HYZY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2100 WEBSTER ST STE 319
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2377
Mailing Address - Country:US
Mailing Address - Phone:415-923-3123
Mailing Address - Fax:415-923-3132
Practice Address - Street 1:2100 WEBSTER ST STE 319
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2377
Practice Address - Country:US
Practice Address - Phone:415-923-3123
Practice Address - Fax:415-923-3132
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007172363A00000X
CAPA59078363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant