Provider Demographics
NPI:1922038314
Name:HODDICK, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:HODDICK
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 1:2125 OAK GROVE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2536
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7171
Practice Address - Street 1:2125 OAK GROVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2536
Practice Address - Country:US
Practice Address - Phone:925-296-7150
Practice Address - Fax:925-296-7171
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG422932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48904Medicare UPIN
CA00G4229311Medicare PIN
CA940000058Medicare PIN
CAAN608ZMedicare PIN
CA00G4229316Medicare PIN
CA00G4229319Medicare PIN
CA00G4229320Medicare PIN
CA00G422930Medicare PIN
CA00G4229314Medicare PIN
CA00G422932Medicare PIN
CA300039418Medicare PIN
CA300104833Medicare PIN
CAAN608YMedicare PIN
CA00G4229312Medicare PIN
CA00G4229315Medicare PIN
CA00G422936Medicare PIN
CA00G4229310Medicare PIN
CAAN383ZMedicare PIN
CA00G422931Medicare PIN
CA00G422934Medicare PIN
CA00G422937Medicare PIN
CAAN488ZMedicare PIN
CA00G4229313Medicare PIN
CA00G4229317Medicare PIN