Healthcare Provider Details

I. General information

NPI: 1629000591
Provider Name (Legal Business Name): ALAN DAVID HUBER P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/22/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 475
FPO AP
96350-9998
US

IV. Provider business mailing address

NAVAL HOSPITAL YOKOSUKA
FPO AP
96350
US

V. Phone/Fax

Practice location:
  • Phone: 46-816-7144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA14885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: