Provider Demographics
NPI:1174824726
Name:HOAGLIN, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:HOAGLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 30TH ST STE 407
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3306
Mailing Address - Country:US
Mailing Address - Phone:415-735-6453
Mailing Address - Fax:415-548-2181
Practice Address - Street 1:400 30TH ST STE 407
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3306
Practice Address - Country:US
Practice Address - Phone:415-735-6453
Practice Address - Fax:415-548-2181
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-14
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1466442084P0015X, 2084P0800X, 2084P0800X
TXS36702084P0015X, 261QM0850X
CODR.00621232084P0015X, 261QM0850X
PAMD4656012084P0015X, 261QM0850X
FLME1437692084P0015X, 261QM0850X, 261QM0850X
AK1329252084P0015X
NC2019-01766261QM0850X
NY292908261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health