Healthcare Provider Details

I. General information

NPI: 1699952515
Provider Name (Legal Business Name): RALPH P. HOYAL, DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 4TH ST STE B
SANTA ROSA CA
95404-4329
US

IV. Provider business mailing address

1041 4TH ST STE B
SANTA ROSA CA
95404-4329
US

V. Phone/Fax

Practice location:
  • Phone: 707-546-2107
  • Fax: 707-573-0315
Mailing address:
  • Phone: 707-546-2107
  • Fax: 707-573-0315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. RALPH P. HOYAL
Title or Position: PODIATRIST
Credential: D.P.M.
Phone: 707-546-2107