Healthcare Provider Details

I. General information

NPI: 1093849408
Provider Name (Legal Business Name): DONALD A HOBSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W FAIRVIEW BLVD
INGLEWOOD CA
90302-1202
US

IV. Provider business mailing address

107 W FAIRVIEW BLVD
INGLEWOOD CA
90302-1202
US

V. Phone/Fax

Practice location:
  • Phone: 310-672-7299
  • Fax: 310-677-9164
Mailing address:
  • Phone: 310-672-7299
  • Fax: 310-677-9164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number33099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: