Provider Demographics
NPI:1861423600
Name:HALL, JOHN L (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 250610
Mailing Address - Street 2:SFO MEDICAL CLINIC SAN FRANCISCO INTL AIRPORT
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94125-0610
Mailing Address - Country:US
Mailing Address - Phone:650-821-5601
Mailing Address - Fax:650-821-5662
Practice Address - Street 1:SFO MEDICAL CLINIC SAN FRANCISCO INTL AIRPORT
Practice Address - Street 2:TERMINAL 2 LOWER LEVEL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94125
Practice Address - Country:US
Practice Address - Phone:650-821-5601
Practice Address - Fax:650-821-5662
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC50025207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F72908Medicare UPIN
CA00C500251Medicare ID - Type Unspecified