Individual provider Active NPI

Julie A, Hodge, M.D.

  • MOHS-Micrographic Surgery Physician
  • Fullerton, CA
National Provider Identifier
1629150396
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
A48399 Issued in CA
Practice address
1440 N Harbor Blvd Ste 300
Fullerton, CA 92835-4116
Phone
(714) 526-7546
Fax
(714) 526-7547
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X A48399 CA Primary

Addresses

Primary practice location

1440 N Harbor Blvd Ste 300
Fullerton, CA 92835-4116

Mailing address

1440 N Harbor Blvd Ste 300
Fullerton, CA 92835-4116
Phone (714) 526-7546

Other practice location 1

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040930001079 CA Practitioner - Dermatology 5890764435 Reassigns benefits to 2 organizations
I20200722003715 MN Practitioner - Dermatology 5890764435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uci Department of DermatologyGroup PAC ID 7113920992, 38 clinicians
Mille Lacs Health SystemGroup PAC ID 4789577834, 47 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7004

200 Elm St N
Onamia, MN 56359-7901

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Mille Lacs Health System Hospital, Onamia, MN, CCN 241356

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A48399CAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc Mohs-Micrographic Surgery CurrentSince May 20, 2019 Accepting new patients
Mille Lacs Health System CurrentSince Jul 10, 2020 Accepting new patients
Mille Lacs Health System CurrentSince Jul 10, 2020 Accepting new patients
Uci Department of Dermatology CurrentSince Mar 1, 2025 Accepting new patients

Locations

1440 N Harbor Blvd
Ste 300
Fullerton, CA 92835
Phone (714) 526-7546

30201 Golden Lantern
Ste B
Laguna Niguel, CA 92677
Phone (949) 363-1788

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

200 S Manchester Ave
Ste 650
Orange, CA 92868
Phone (714) 456-3077

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

Organizations & group practices 4

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1629150396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 300",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354116",
            "telephone_number": "714-526-7546",
            "fax_number": "714-526-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N HARBOR BLVD STE 300",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354116",
            "telephone_number": "714-526-7546",
            "fax_number": "714-526-7547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 The City Dr S",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-456-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGE",
        "first_name": "JULIE",
        "middle_name": "A,",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A48399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.