Healthcare Provider Details
I. General information
NPI: 1568496537
Provider Name (Legal Business Name): KRISTINA G HOBSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14850 LOS GATOS BLVD
LOS GATOS CA
95032-2011
US
IV. Provider business mailing address
14850 LOS GATOS BLVD
LOS GATOS CA
95032-2011
US
V. Phone/Fax
- Phone: 408-358-2868
- Fax: 408-358-6787
- Phone: 408-358-2868
- Fax: 408-358-6787
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | A65767 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: