Healthcare Provider Details

I. General information

NPI: 1669891503
Provider Name (Legal Business Name): SAMMY HODROGE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 08/10/2025
Certification Date: 08/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 CLINTON AVE ALAMEDA HOSPITAL ER
ALAMEDA CA
94501
US

IV. Provider business mailing address

25 CAMP ST APT 2
SAN FRANCISCO CA
94110-1145
US

V. Phone/Fax

Practice location:
  • Phone: 510-522-3700
  • Fax:
Mailing address:
  • Phone: 304-380-8709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number27078
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA153624
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: