Provider Demographics
NPI:1558954545
Name:MICHAEL C HOAGLIN, MD, INC
Entity Type:Organization
Organization Name:MICHAEL C HOAGLIN, MD, INC
Other - Org Name:PROTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOAGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-735-6453
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty