Provider Demographics
NPI:1629125968
Name:JOHN S HEGE MD INC
Entity Type:Organization
Organization Name:JOHN S HEGE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STEELE
Authorized Official - Last Name:HEGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-832-4261
Mailing Address - Street 1:3300 WEBSTER STREET
Mailing Address - Street 2:#602
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609
Mailing Address - Country:US
Mailing Address - Phone:510-834-5427
Mailing Address - Fax:510-834-5449
Practice Address - Street 1:3300 WEBSTER STREET
Practice Address - Street 2:#602
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-834-5427
Practice Address - Fax:510-834-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21253207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A212530Medicaid
00A212530Medicare ID - Type Unspecified