Provider Demographics
NPI:1801121728
Name:HAMPTON HEALTH LTD
Entity type:Organization
Organization Name:HAMPTON HEALTH LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:MCELROY
Authorized Official - Last Name:FULLERTON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:415-706-4825
Mailing Address - Street 1:1700 CALIFORNIA ST
Mailing Address - Street 2:SUITE 470
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4586
Mailing Address - Country:US
Mailing Address - Phone:415-202-9990
Mailing Address - Fax:415-202-0102
Practice Address - Street 1:1700 CALIFORNIA STREET
Practice Address - Street 2:SUITE 470
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109
Practice Address - Country:US
Practice Address - Phone:414-202-9990
Practice Address - Fax:415-202-9991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16412261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care