Provider Demographics
NPI:1730221821
Name:HOPPE, RICHARD THOMAS (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:THOMAS
Last Name:HOPPE
Suffix:
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 1:875 BLAKE WILBUR DRIVE
Mailing Address - Street 2:ROOM CC-G224
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5847
Mailing Address - Country:US
Mailing Address - Phone:650-723-5510
Mailing Address - Fax:650-498-6922
Practice Address - Street 1:875 BLAKE WILBUR DRIVE
Practice Address - Street 2:ROOM CC-G224
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5847
Practice Address - Country:US
Practice Address - Phone:650-723-5510
Practice Address - Fax:650-498-6922
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG237432085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G237430Medicaid
CAA42056Medicare UPIN
CA00G237430Medicare ID - Type Unspecified