Dr Ian Christopher Hopper, DO | |
1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 | |
(707) 559-7500 | |
Not Available |
Full Name | Dr Ian Christopher Hopper |
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Gender | Male |
Speciality | Pediatrics |
Location | 1179 N Mcdowell Blvd, Petaluma, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396206587 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 125.074943 (Illinois) | Secondary |
208000000X | Pediatrics | 20A19517 (California) | Primary |
Entity Name | Providence Medical Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346 |
Mailing Address | Practice Location Address |
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Dr Ian Christopher Hopper, DO 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 Ph: (707) 559-7500 | Dr Ian Christopher Hopper, DO 1179 N Mcdowell Blvd, Petaluma, CA 94954-6559 Ph: (707) 559-7500 |
Dr. Lindsey Hibbard, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3900 Lakeville Hwy, Petaluma, CA 94954 Phone: 707-765-3920 Fax: 707-765-3461 | |
Mrs. Faye Susan Lundergan, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1456 Professional Dr Ste 405, Petaluma, CA 94954 Phone: 707-769-7500 Fax: 707-769-7570 | |
Donald S. Hensley, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3900 Lakeville Hwy, Petaluma, CA 94954 Phone: 707-765-3900 | |
Dr. Eric D. Scher, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 400 4th St, Petaluma, CA 94952 Phone: 415-846-9160 | |
Carol A. Ekelund, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3900 Lakeville Hwy, Petaluma, CA 94954 Phone: 707-765-3900 | |
Ms. Martha E Cueto-salas, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1179 N Mcdowell Blvd, Petaluma, CA 94954 Phone: 707-559-7500 Fax: 707-559-7707 |