Provider Demographics
NPI:1215048632
Name:MABEN, HAYWARD CLINTON III (MD)
Entity type:Individual
Prefix:DR
First Name:HAYWARD
Middle Name:CLINTON
Last Name:MABEN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:401 DOLORES ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1008
Mailing Address - Country:US
Mailing Address - Phone:415-613-4789
Mailing Address - Fax:415-861-7779
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:SUITE 1010
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3117
Practice Address - Country:US
Practice Address - Phone:510-451-1875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-02-11
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Provider Licenses
StateLicense IDTaxonomies
CAG68853207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF37895Medicare UPIN