Provider Demographics
NPI:1295924025
Name:DEOCAMPO, HILARIO NICHOLAS III
Entity type:Individual
Prefix:MR
First Name:HILARIO
Middle Name:NICHOLAS
Last Name:DEOCAMPO
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 S SPRUCE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-4557
Mailing Address - Country:US
Mailing Address - Phone:415-375-7598
Mailing Address - Fax:650-620-9549
Practice Address - Street 1:170 S SPRUCE AVE STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-4557
Practice Address - Country:US
Practice Address - Phone:415-375-7598
Practice Address - Fax:650-620-9549
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker