Individual
MICAH D HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1390 MARKET ST STE 200, SAN FRANCISCO, CA 94102-5404
(877) 834-0008
(415) 558-1764
Mailing address
PO BOX 27646, SCOTTSDALE, AZ 85255-0144
(831) 818-9833
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20A8534
CA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
005389
AZ
207Q00000X
Family Medicine Physician
20A8534
CA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
20A-8534
CA
207QA0401X
Addiction Medicine (Family Medicine) Physician
5389
AZ
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
20A-8534
CA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
5389
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972506616
—
CA
Enumeration date
05/25/2005
Last updated
12/13/2022
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