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General NPI Number Information
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NPI Number | 1205061959
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Entity Type | Individual
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Provider Name | PATRICK LENORD HOGUE FNP-BC, DNP
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Gender | Male
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 26520 CACTUS AVE
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City | MORENO VALLEY
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State | CA
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Zip | 92555-3927
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Country | US
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Telephone | 951-486-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 10992 MORO ST
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City | LOMA LINDA
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State | CA
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Zip | 92354-6109
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Country | US
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Telephone | 240-461-2111
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Fax |
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 664336
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95011979
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License Number State | CA
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