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General NPI Number Information
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NPI Number | 1326645391
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Entity Type | Individual
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Provider Name | H DIJON HYDER
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Gender | Male
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Dates
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Enumeration Date | 10/02/2020
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 15000 7TH ST STE 208C
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City | VICTORVILLE
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State | CA
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Zip | 92395-3853
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Country | US
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Telephone | 760-998-1487
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Fax |
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Provider Business Mailing Address
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Address Line | 11824 DELLWOOD RD
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City | VICTORVILLE
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State | CA
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Zip | 92392-1292
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Country | US
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Telephone | 760-662-0424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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