Provider Demographics
NPI:1063645869
Name:NATUROPATHIC WISDOM
Entity Type:Organization
Organization Name:NATUROPATHIC WISDOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGG
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:408-297-6877
Mailing Address - Street 1:1101 S WINCHESTER BLVD
Mailing Address - Street 2:STE E157
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3901
Mailing Address - Country:US
Mailing Address - Phone:408-297-6877
Mailing Address - Fax:408-296-6894
Practice Address - Street 1:1101 S WINCHESTER BLVD
Practice Address - Street 2:STE E157
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3901
Practice Address - Country:US
Practice Address - Phone:408-297-6877
Practice Address - Fax:404-829-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-125175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty