Provider Demographics
NPI:1194721035
Name:HILDEBRANDT, HANS-JOACHIM A (MD)
Entity type:Individual
Prefix:DR
First Name:HANS-JOACHIM
Middle Name:A
Last Name:HILDEBRANDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 E FIR AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3808
Mailing Address - Country:US
Mailing Address - Phone:559-256-1975
Mailing Address - Fax:559-256-1989
Practice Address - Street 1:1867 E FIR AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3808
Practice Address - Country:US
Practice Address - Phone:559-325-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG763782085R0202X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G763780Medicaid
CA00G763780Medicaid
CA00G763780Medicaid