Wally Hosn, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A69516 Issued in CA

Practice address

1250 Peach St
Suite D
San Luis Obispo, CA 93401-2837

Phone

(805) 541-0330

Fax

(805) 541-6809

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1275517856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PEACH ST",
            "address_2": "SUITE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012837",
            "telephone_number": "805-541-0330",
            "fax_number": "805-541-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PEACH ST",
            "address_2": "SUITE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012837",
            "telephone_number": "805-541-0330",
            "fax_number": "805-541-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSN",
        "first_name": "WALLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A69516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Horak
• Gene Hori, M.D.
• Elaine Lois Hortillosa
• Gerry B Hortillosa
• Arnold Martin Horwitz, PH.D.
• Hospice Partners, Inc.
• Alexandria W Hotmer, PSYD
• Zoe Hotmer
• Ellyn Houghton, MSCCC-A
• Todd Michael Hove

• Plastic Surgery Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.