Provider Demographics
NPI:1053375188
Name:HILLIARD, DENISE MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:MARIA
Last Name:HILLIARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT 34929
Mailing Address - Street 2:P.O. BOX 39000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-0001
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:907 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4036
Practice Address - Country:US
Practice Address - Phone:925-837-1044
Practice Address - Fax:925-837-1055
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00999676OtherRAILROAD MEDICARE
CA00A729590Medicaid
CAH21463Medicare UPIN
CAP00999676OtherRAILROAD MEDICARE
CAEE366ZMedicare PIN