| Dorothy E Hairston M D A Professional Corporation | |
|
10531 4s Commons Dr # 144 San Diego CA 92127-3517 | |
| (646) 526-5142 | |
| Not Available |
| Full Name | Dorothy E Hairston M D A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 10531 4s Commons Dr # 144, San Diego, California |
| Authorized Official Name and Position | Dorothy E Hairston (OWNER) |
| Authorized Official Contact | 6194724690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dorothy E Hairston M D A Professional Corporation 10531 4s Commons Dr # 144 San Diego CA 92127-3517 Ph: (646) 526-5142 | Dorothy E Hairston M D A Professional Corporation 10531 4s Commons Dr # 144 San Diego CA 92127-3517 Ph: (646) 526-5142 |
| NPI Number | 1700189693 |
|---|---|
| Provider Enumeration Date | 12/15/2010 |
| Last Update Date | 03/18/2024 |
| Medicare PECOS PAC ID | 6901089580 |
|---|---|
| Medicare Enrollment ID | O20110318000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700189693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A78226 (California) | Primary |
| Provider Name | Dorothy E Hairston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114973633 PECOS PAC ID: 5496789257 Enrollment ID: I20050921000394 |
| Provider Name | Kirk Anthony Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710406848 PECOS PAC ID: 8820334824 Enrollment ID: I20190111002541 |
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