Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | G23892 | CA |
NPI | 1285676304 |
---|---|
Provider Name | William H Hawk |
First Address | Oakland, CA 94609-1809 |
Second Address | Oakland, CA 94609-1809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0095780 | (05) | CA |