Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A063027 | CA |
NPI | 1659330645 |
---|---|
Provider Name | Dr. John Mark Hilinski |
First Address | San Diego, CA 92103-4203 |
Second Address | San Diego, CA 92103-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 02/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
203193670 | CORPORATE ID (01) | CA |