Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD433648 | PA |
NPI | 1154589885 |
---|---|
Provider Name | Toshitaka Hoppo |
First Address | Mc Murray, PA 15317-2690 |
Second Address | Mc Murray, PA 15317-2690 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 06/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102166135-0002 | (05) | PA |
2941320 | (05) | OH |