Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | AC1283 | CA |
NPI | 1245352236 |
---|---|
Provider Name | Dr. George Hoke |
First Address | Sonoma, CA 95476-6625 |
Second Address | Sonoma, CA 95476-6625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AC1283 | ACUPUNCTURE (01) | CA |