Healthcare Provider Details

I. General information

NPI: 1659325892
Provider Name (Legal Business Name): DAVID LOUIS HOBAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 RIVERSIDE AVE
SANTA CRUZ CA
95060-4517
US

IV. Provider business mailing address

831 RIVERSIDE AVE
SANTA CRUZ CA
95060-4517
US

V. Phone/Fax

Practice location:
  • Phone: 831-429-6617
  • Fax:
Mailing address:
  • Phone: 831-429-6617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG21690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: