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Individual

XAVIER COSTOLINO HOGAN SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
115 N CHESTER AVE, COMPTON, CA 90221-2701
(313) 106-3599
Mailing address
115 N CHESTER AVE, COMPTON, CA 90221-2701
(313) 106-3599

Taxonomy

Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
198320468
CA

Other

Enumeration date
04/07/2025
Last updated
04/07/2025
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