Healthcare Provider Details

I. General information

NPI: 1578734174
Provider Name (Legal Business Name): STEVEN CLARK HOBBS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2008
Last Update Date: 03/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 30TH ST STE 115
SAN DIEGO CA
92116-4245
US

IV. Provider business mailing address

4535 30TH ST STE 115
SAN DIEGO CA
92116-4245
US

V. Phone/Fax

Practice location:
  • Phone: 432-352-8315
  • Fax:
Mailing address:
  • Phone: 432-352-8315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number30763
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: