Provider Demographics
NPI:1972801926
Name:HOCKETT, RICHARD DEANE JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEANE
Last Name:HOCKETT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1921
Mailing Address - Country:US
Mailing Address - Phone:317-217-9507
Mailing Address - Fax:
Practice Address - Street 1:10520 WATERIDGE CIR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-5782
Practice Address - Country:US
Practice Address - Phone:317-217-9507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG89185207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology