Provider Demographics
NPI:1952305294
Name:HILDEBRAND, STEVEN W (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:W
Last Name:HILDEBRAND
Suffix:
Gender:M
Credentials:MD, FACC
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 2200
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-0722
Mailing Address - Country:US
Mailing Address - Phone:951-845-0313
Mailing Address - Fax:951-845-8194
Practice Address - Street 1:6109 W RAMSEY ST
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-3051
Practice Address - Country:US
Practice Address - Phone:951-845-0313
Practice Address - Fax:951-845-8194
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500937207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0227UOtherBCBS NC GROUP ID #
NC582333928OtherNC TAX ID USED BY INS COS
SCNPA709Medicaid
NC42353OtherBCBS NC INDIVIDUAL ID #
NC890227UMedicaid
NC8942353Medicaid
NC2214117AMedicare ID - Type UnspecifiedINDIVIDUAL MD PROVIDER #
NC582333928OtherNC TAX ID USED BY INS COS
NC42353OtherBCBS NC INDIVIDUAL ID #