Healthcare Provider Details

I. General information

NPI: 1851586507
Provider Name (Legal Business Name): JASON M. HOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 37TH AVE 3RD FLOOR
SAN MATEO CA
94403-4324
US

IV. Provider business mailing address

610 BUCKWHEAT CT APT 1104
HAYWARD CA
94544-5556
US

V. Phone/Fax

Practice location:
  • Phone: 650-573-2530
  • Fax:
Mailing address:
  • Phone: 213-444-6533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA102592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: