Provider Demographics
NPI:1972687101
Name:HOCKENBURY, STEPHEN ALDEN (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:ALDEN
Last Name:HOCKENBURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:177 RIVERSIDE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4032
Mailing Address - Country:US
Mailing Address - Phone:949-837-7226
Mailing Address - Fax:949-475-1601
Practice Address - Street 1:1601 DOVE ST
Practice Address - Street 2:SUITE 230
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1423
Practice Address - Country:US
Practice Address - Phone:949-837-7226
Practice Address - Fax:949-475-1601
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA658642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A65864Medicare ID - Type Unspecified
H33981Medicare UPIN