Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 48914 | CA |
NPI | 1083019129 |
---|---|
Provider Name | Barry Hoch |
First Address | San Ramon, CA 94583-4440 |
Second Address | San Ramon, CA 94583-4440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2014 |
Last Update Date | 31/10/2014 |