Individual
DR. DAVID RANDEEN HOOVESTOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 S AVENUE A, YUMA, AZ 85364-7127
(928) 336-7100
(928) 336-7508
Mailing address
PO BOX 660969, ARCADIA, CA 91066-0969
(626) 447-0296
(626) 447-6057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22168
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190538
—
AZ
05
—
XPY190972
—
AZ
Enumeration date
07/10/2006
Last updated
06/23/2008
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