Provider Demographics
NPI:1780699538
Name:HALIO, AMY A (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:A
Last Name:HALIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 22210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-2210
Mailing Address - Country:US
Mailing Address - Phone:510-535-4000
Mailing Address - Fax:510-535-4225
Practice Address - Street 1:50 E. LEWELLING BLVD
Practice Address - Street 2:RM S-5
Practice Address - City:SAN LORENZO
Practice Address - State:CA
Practice Address - Zip Code:94580-1732
Practice Address - Country:US
Practice Address - Phone:510-317-3167
Practice Address - Fax:510-276-5483
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2013-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG57684208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSP40611FMedicaid
CAHSP40611FMedicaid