Individual
DR. ANN HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
25 MITCHELL BLVD, #3, SAN RAFAEL, CA 94903-2007
(415) 499-0966
(415) 446-0118
Mailing address
48 MAHOGANY DR, SAN RAFAEL, CA 94903-3132
(415) 472-6849
(415) 446-0118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G42615
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G426151
—
CA
Enumeration date
11/01/2006
Last updated
07/08/2007
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