Provider Demographics
NPI:1902869621
Name:HILE, DANIEL III (OD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HILE
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 VINE STREET
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446
Mailing Address - Country:US
Mailing Address - Phone:805-610-2006
Mailing Address - Fax:805-610-2006
Practice Address - Street 1:1112 VINE ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-5505
Practice Address - Country:US
Practice Address - Phone:805-238-1001
Practice Address - Fax:805-237-1057
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11356T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD011356DMedicaid
CAU86004Medicare UPIN
CA0312300001Medicare NSC
CA0312300002Medicare NSC
CAWOP11356BMedicare ID - Type Unspecified
CASD011356DMedicaid