Provider Demographics
NPI:1114944618
Name:HOPPE, DIANA E (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:E
Last Name:HOPPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 N EL CAMINO REAL
Mailing Address - Street 2:SUITE #310
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2811
Mailing Address - Country:US
Mailing Address - Phone:760-635-5600
Mailing Address - Fax:760-635-5642
Practice Address - Street 1:317 N EL CAMINO REAL
Practice Address - Street 2:SUITE #310
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2811
Practice Address - Country:US
Practice Address - Phone:760-635-5600
Practice Address - Fax:760-635-5642
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69638174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF11550Medicare UPIN