Healthcare Provider Details

I. General information

NPI: 1649284316
Provider Name (Legal Business Name): ALLEN DIRK HOEK OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1048 W MAIN ST
RIPON CA
95366-2326
US

IV. Provider business mailing address

1048 W MAIN ST
RIPON CA
95366-2326
US

V. Phone/Fax

Practice location:
  • Phone: 209-599-2216
  • Fax: 209-599-6420
Mailing address:
  • Phone: 209-599-2216
  • Fax: 209-599-6420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT8741
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: