Healthcare Provider Details

I. General information

NPI: 1245352236
Provider Name (Legal Business Name): GEORGE HOKE OMD, L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NED HOKE OMD,L.AC.

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 W NAPA ST
SONOMA CA
95476-6625
US

IV. Provider business mailing address

166 W NAPA ST
SONOMA CA
95476-6625
US

V. Phone/Fax

Practice location:
  • Phone: 707-996-4511
  • Fax:
Mailing address:
  • Phone: 707-996-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberAC1283
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: