Healthcare Provider Details

I. General information

NPI: 1720054265
Provider Name (Legal Business Name): RACHEL K HURLBURT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 VALLEY VIEW DR
QUINCY CA
95971
US

IV. Provider business mailing address

1065 BUCKS LAKE RD
QUINCY CA
95971
US

V. Phone/Fax

Practice location:
  • Phone: 530-283-5640
  • Fax: 530-283-3541
Mailing address:
  • Phone: 530-283-2121
  • Fax: 530-283-7953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A7712
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: