Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | A45615 | CA |
NPI | 1477533727 |
---|---|
Provider Name | Dr. William Michael Hogan |
First Address | Ventura, CA 93003-2909 |
Second Address | Ventura, CA 93003-2909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 30/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C29771 | (02) | CA |