MEDICARE: ERIC RODNEY HUBBARD DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E1294	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831206036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC RODNEY HUBBARD DPM

Provider Business Mailing Address
First Line	:	2333 PACIFIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-3025
Country	:	US
Telephone Number	:	562-426-5151
Fax Number	:	562-424-3395

Provider Business Practice Location Address
First Line	:	2333 PACIFIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-3025
Country	:	US
Telephone Number	:	562-426-5151
Fax Number	:	562-424-3395

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	04/25/2014

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