Provider Demographics
NPI:1962637306
Name:HOOVER, KRISTEN SUEOKA (MD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:SUEOKA
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:TOMIKO
Other - Last Name:SUEOKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:275 W MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5641
Mailing Address - Country:US
Mailing Address - Phone:510-752-6542
Mailing Address - Fax:
Practice Address - Street 1:3801 HOWE ST
Practice Address - Street 2:3RD FLOOR, FABIOLA 3A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5312
Practice Address - Country:US
Practice Address - Phone:510-752-6542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107894207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine