Provider Demographics
NPI:1235139346
Name:HOGEN, VICTOR S JR (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:S
Last Name:HOGEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:11550 INDIAN HILLS RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1200
Mailing Address - Country:US
Mailing Address - Phone:818-365-2567
Mailing Address - Fax:818-365-5967
Practice Address - Street 1:11550 INDIAN HILLS RD
Practice Address - Street 2:SUITE 330
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1200
Practice Address - Country:US
Practice Address - Phone:818-365-2567
Practice Address - Fax:818-365-5967
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2008-11-11
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
CAG355432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG35543Medicare UPIN