Organization
DWIGHT HISCOX, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT HISCOX (PRESIDENT)
(818) 550-0900
Entity
Organization
Contact information
Practice address
1509 WILSON TER, GLENDALE, CA 91206-4007
(818) 550-0900
Mailing address
PO BOX 951, GLENDALE, CA 91209-0951
(818) 550-0900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G348050
BLUESHIELD
CA
Enumeration date
11/05/2007
Last updated
11/05/2007
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