MEDICARE: DIANE L. HUTCHISON, MD, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		CA

General Provider Information

NPI Number	:	1417933029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANE L. HUTCHISON, MD, INC.

Provider Business Mailing Address
First Line	:	PO BOX 230656
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92023-0656
Country	:	US
Telephone Number	:	760-634-6922
Fax Number	:

Provider Business Practice Location Address
First Line	:	477 N EL CAMINO REAL
Second Line	:	SUITE D202
City	:	ENCINITAS
State	:	CA
Zip	:	92024-1328
Country	:	US
Telephone Number	:	760-634-6922
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. DIANE HUTCHISON
Credential	:	M.D.
Telephone Number	:	760-634-6922

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	07/21/2022

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