Provider Demographics
NPI:1134169600
Name:HOECK PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:HOECK PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:HOECK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:858-455-1195
Mailing Address - Street 1:9404 GENESEE AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1339
Mailing Address - Country:US
Mailing Address - Phone:858-455-1195
Mailing Address - Fax:
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:858-455-1195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX IDENTIFICATION