Basic Information
| Provider Information | |||||||||
| NPI: | 1740288836 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAY | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2222 EAST ST | ||||||||
| Address2: | STE 250 | ||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256896211 | ||||||||
| FaxNumber: | 9256893857 | ||||||||
| Practice Location | |||||||||
| Address1: | 2222 EAST ST | ||||||||
| Address2: | STE 250 | ||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256896211 | ||||||||
| FaxNumber: | 9256893857 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | A18121 | CA | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | GR0067920 | 05 | CA | MEDICAID |