=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790888782
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DARREL E HOPKINS, D.O., A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2006
-----------------------------------------------------
Last Update Date | 02/20/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20241 SW BIRCH ST SUITE 100
-----------------------------------------------------
City | NEWPORT BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92660-1782
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-222-0739
-----------------------------------------------------
Fax | 949-222-0890
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20241 SW BIRCH ST SUITE 100
-----------------------------------------------------
City | NEWPORT BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92660-1782
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-222-0739
-----------------------------------------------------
Fax | 949-222-0890
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. DARREL E. HOPKINS
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 949-222-0739
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 20A5376
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------