Provider Demographics
NPI:1588781959
Name:HAWK, MARK A (NP)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:HAWK
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Gender:M
Credentials:NP
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Mailing Address - Street 1:1001 POTRERO AVE # 3B
Mailing Address - Street 2:SFGH SURGERY DEPARTMENT
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-4073
Mailing Address - Fax:415-206-6293
Practice Address - Street 1:1001 POTRERO AVE # 3B
Practice Address - Street 2:SFGH SURGERY DEPARTMENT
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-4073
Practice Address - Fax:415-206-6293
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN387281163WM0705X
CANPF11216363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
976753OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER