Healthcare Provider Details

I. General information

NPI: 1174824726
Provider Name (Legal Business Name): MICHAEL C HOAGLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2010
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 30TH ST STE 407
OAKLAND CA
94609-3306
US

IV. Provider business mailing address

400 30TH ST STE 407
OAKLAND CA
94609-3321
US

V. Phone/Fax

Practice location:
  • Phone: 415-735-6453
  • Fax: 415-548-2181
Mailing address:
  • Phone: 415-735-6453
  • Fax: 415-548-2181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA146644
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberS3670
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberA146644
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number132925
License Number StateAK
# 5
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberDR.0062123
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberMD465601
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberME143769
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: