Xavier Costolino Hogan Sr.

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

License

198320468 Issued in CA

Practice address

115 N Chester Ave
Compton, CA 90221-2701

Phone

(313) 106-3599

NPI assigned

Apr 7, 2025

Last updated

Apr 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Quincy Manor LLC

  • Nursing Facility/Intermediate Care Facility
  • Compton, CA
  • NPI 1003600800
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1235923343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N CHESTER AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902212701",
            "telephone_number": "313-106-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N CHESTER AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902212701",
            "telephone_number": "313-106-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "XAVIER",
        "middle_name": "COSTOLINO",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "CA",
            "license": "198320468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tania Hill
• Michael D. Hoang, ATC
• Hoangson Dao DDS & Michael Dao DMD
• Ercell H Hoffman, LMFT
• Justin Hogan
• Jeremy Holden
• Veverly Juanettia Holiwell, ASW
• Brandon Holley
• Katina Latrice Holliday
• Misha Kipanda Hollins

• Nursing Home Administrator in Compton, CA
• Providers in Compton, CA by specialty
• Nursing Home Administrator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.