Basic Information
Provider Information
NPI: 1760461354
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ELKIN
FirstName: HILARY
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 209 RHEEM BLVD
Address2:  
City: ORINDA
State: CA
PostalCode: 945633622
CountryCode: US
TelephoneNumber: 9252538222
FaxNumber:  
Practice Location
Address1: 150 MUIR RD
Address2:  
City: MARTINEZ
State: CA
PostalCode: 945534668
CountryCode: US
TelephoneNumber: 9253722131
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/11/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X523487CAX Nursing Service ProvidersRegistered Nurse 
363L00000X11842CAX Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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