Healthcare Provider Details

I. General information

NPI: 1154589885
Provider Name (Legal Business Name): TOSHITAKA HOPPO M.D. PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 GALLERY DR
MC MURRAY PA
15317-2690
US

IV. Provider business mailing address

138 GALLERY DR
MC MURRAY PA
15317-2690
US

V. Phone/Fax

Practice location:
  • Phone: 412-267-6290
  • Fax: 412-267-6291
Mailing address:
  • Phone: 412-267-6290
  • Fax: 412-267-6291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA12025400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD433648
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: