Provider Demographics
NPI:1154961142
Name:HOAG PHYSCIAN PARTNERS
Entity type:Organization
Organization Name:HOAG PHYSCIAN PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:CONK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-517-3139
Mailing Address - Street 1:16148 SAND CANYON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2995 RED HILL AVE
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5976
Practice Address - Country:US
Practice Address - Phone:949-791-3445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOAG MEMORIAL HOSPITAL PRESBYTERIAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-08
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization