Healthcare Provider Details

I. General information

NPI: 1538514153
Provider Name (Legal Business Name): HUNTER VINCENT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HUNTER MALONEY D.O.

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 10/06/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 Y STREET, SUITE 3850
SACRAMENTO CA
95817
US

IV. Provider business mailing address

22287 MULHOLLAND HWY # 526
CALABASAS CA
91302-5157
US

V. Phone/Fax

Practice location:
  • Phone: 805-975-0006
  • Fax:
Mailing address:
  • Phone: 805-975-0006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number20A15296
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: