Individual provider Active NPI

Harry Frank Hlavac, D.P.M.

  • Podiatrist
  • Mill Valley, CA
National Provider Identifier
1386838241
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E-01278 Issued in CA
Practice address
619 E Blithedale Ave
Ste B
Mill Valley, CA 94941-1468
Phone
(415) 464-9577
Fax
(415) 464-9577
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E-01278 CA Primary

Addresses

Primary practice location

619 E Blithedale Ave
Ste B
Mill Valley, CA 94941-1468

Mailing address

619 E Blithedale Ave
Ste B
Mill Valley, CA 94941-1468
Phone (415) 464-9577

Other identifiers 1

IdentifierTypeStateIssuer
E-01278OtherCASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E-01278CAMDPodiatrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1386838241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E BLITHEDALE AVE",
            "address_2": "STE B",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411468",
            "telephone_number": "415-464-9577",
            "fax_number": "415-464-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E BLITHEDALE AVE",
            "address_2": "STE B",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411468",
            "telephone_number": "415-464-9577",
            "fax_number": "415-464-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLAVAC",
        "first_name": "HARRY",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E-01278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E-01278",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.