Basic Information
| Provider Information | |||||||||
| NPI: | 1710967906 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALL | ||||||||
| FirstName: | KRIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1740 ROSECRANS ST | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921061928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6197907800 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1325 BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | ROCKPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783823333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617290646 | ||||||||
| FaxNumber: | 3617298854 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2006 | ||||||||
| LastUpdateDate: | 02/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | A62482 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | L8359 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.