Basic Information
| Provider Information | |||||||||
| NPI: | 1114117223 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAWKINS | ||||||||
| FirstName: | BRYAN | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2125 S. EL CAMINO REAL | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607214000 | ||||||||
| FaxNumber: | 7607214005 | ||||||||
| Practice Location | |||||||||
| Address1: | 2125 S. EL CAMINO REAL | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607214000 | ||||||||
| FaxNumber: | 7607214005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2007 | ||||||||
| LastUpdateDate: | 04/02/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204D00000X | 20A10808 | CA | Y | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | 207Q00000X | 20A10808 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.