Provider Demographics
NPI:1730344821
Name:HILZ, STEVEN H (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:H
Last Name:HILZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 W NUEVO RD STE E&F
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-0858
Mailing Address - Country:US
Mailing Address - Phone:951-943-4949
Mailing Address - Fax:951-943-1067
Practice Address - Street 1:136 W NUEVO RD STE E&F
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-0858
Practice Address - Country:US
Practice Address - Phone:951-943-4949
Practice Address - Fax:951-943-1067
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8491T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0084910Medicaid
CAZZZ23582ZMedicare PIN
CAU25405Medicare UPIN
CA5366610001Medicare NSC