Hendricks, Douglas L
Hendricks, Douglas L is an sole proprietor health care provider with primary practice located at 280 Newport Center Dr Suite 120, Newport Beach CA 92660-7526. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery of the Hand, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Hendricks, Douglas L can be contacted via phone (949) 640-9570.Contact Information
Primary practice address
280 Newport Center Dr Suite 120
Newport Beach CA 92660-7526
Phone: (949) 640-9570
Fax: (949) 640-9569
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery of the Hand | 2082S0105X | G069421 | California |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 036151135 | Illinois |
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | G069421 | California |
Profile Details
| NPI number | 1922165703 |
|---|---|
| LBN Legal business name | Hendricks, Douglas L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Aug 31st, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922165703 | NPPES |
| Wisconsin | MEDICAID | 1922165703 | |
| Wisconsin | MEDICAID | 036151135 |
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