Provider Demographics
NPI:1841618386
Name:RACHEL HOYAL DPM INC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RACHEL HOYAL DPM INC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:707-546-2107
Mailing Address - Street 1:1041 4TH ST
Mailing Address - Street 2:STE. B
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4329
Mailing Address - Country:US
Mailing Address - Phone:707-546-2107
Mailing Address - Fax:707-573-0315
Practice Address - Street 1:1041 4TH ST
Practice Address - Street 2:STE B
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4329
Practice Address - Country:US
Practice Address - Phone:707-546-2107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4883213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7081750001Medicare NSC
CADD252AMedicare PIN