Provider Demographics
NPI:1740502665
Name:HOEGER, CARL JASON (DPM)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:JASON
Last Name:HOEGER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:18952 MAC ARTHUR BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1401
Mailing Address - Country:US
Mailing Address - Phone:949-833-3406
Mailing Address - Fax:949-833-9955
Practice Address - Street 1:18952 MAC ARTHUR BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1401
Practice Address - Country:US
Practice Address - Phone:949-833-3406
Practice Address - Fax:949-833-9955
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2015-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAE5130213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA03383777Medicaid
CA03383777Medicaid