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General NPI Number Information
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NPI Number | 1386223428
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Entity Type | Organization
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Legal Business Name | HOAG AT HOME LLC
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 4041 MACARTHUR BLVD STE 400
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2554
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Country | US
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Telephone | 949-736-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 4041 MACARTHUR BLVD STE 400
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2554
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DORECTOR
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Name | ROBERT DECKER
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Credential | PT
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Telephone | 949-463-1510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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