Provider Demographics
NPI:1700825213
Name:HOECK, DOUGLAS CLIFFORD (PT)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:CLIFFORD
Last Name:HOECK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9404 GENESEE AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1339
Mailing Address - Country:US
Mailing Address - Phone:858-454-8188
Mailing Address - Fax:858-455-7101
Practice Address - Street 1:9404 GENESEE AVE
Practice Address - Street 2:STE 310
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1339
Practice Address - Country:US
Practice Address - Phone:858-454-8188
Practice Address - Fax:858-455-7101
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10032225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist