Provider Demographics
NPI:1538630165
Name:HAWLEY, ALEXANDER PHILLIP I
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:PHILLIP
Last Name:HAWLEY
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 DETROIT AVE APT 33
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-3318
Mailing Address - Country:US
Mailing Address - Phone:509-793-8876
Mailing Address - Fax:
Practice Address - Street 1:901 NEVIN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3143
Practice Address - Country:US
Practice Address - Phone:510-307-3055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-07
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2278P1006X
141815227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No2278P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPulmonary Function Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33861OtherRESPIRATORY CARE BOARD OF CALIFORNIA
141815OtherNATIONL BOARD OF RESPIRATORY CARE