Provider Demographics
NPI:1659325892
Name:HOBAN, DAVID LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LOUIS
Last Name:HOBAN
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 1:831 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4517
Mailing Address - Country:US
Mailing Address - Phone:831-429-6617
Mailing Address - Fax:
Practice Address - Street 1:831 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4517
Practice Address - Country:US
Practice Address - Phone:831-429-6617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG216902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$OtherSSN
A41354Medicare UPIN
CA00G216900Medicare PIN