MEDICARE: STEVEN E HODGKIN MD A PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00065354	OTHER	CA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1699885053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN E HODGKIN MD A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	15366 11TH ST
Second Line	:	SUITE K
City	:	VICTORVILLE
State	:	CA
Zip	:	92395-3726
Country	:	US
Telephone Number	:	760-245-6465
Fax Number	:	760-245-1132

Provider Business Practice Location Address
First Line	:	15366 11TH ST
Second Line	:	SUITE K
City	:	VICTORVILLE
State	:	CA
Zip	:	92395-3726
Country	:	US
Telephone Number	:	760-245-6465
Fax Number	:	760-245-1132

Authorized Official
Title or Position	:	OWNER
Name	:	ROLANDO ATIGA
Credential	:	MD
Telephone Number	:	760-245-6465

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/16/2023

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Directions to “STEVEN E HODGKIN MD A PROFESSIONAL CORPORATION ” Practice Location

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