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General NPI Number Information
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NPI Number | 1063471746
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Entity Type | Individual
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Provider Name | DAVID S. HODGE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 215 N FRESNO ST SUITE 370
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City | FRESNO
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State | CA
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Zip | 93721
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Country | US
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Telephone | 559-440-9740
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Fax | 559-440-9771
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Provider Business Mailing Address
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Address Line | 6235 N FRESNO ST SUITE 106
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City | FRESNO
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State | CA
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Zip | 93710-5269
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Country | US
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Telephone | 559-440-9740
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Fax | 559-440-9771
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | G39325
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License Number State | CA
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