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General NPI Number Information
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NPI Number | 1467655100
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Entity Type | Individual
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Provider Name | JODY A HITCHMAN NP
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Gender | Female
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1818 N ORANGE GROVE AVE #200
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City | POMONA
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State | CA
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Zip | 91767
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Country | US
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Telephone | 909-622-6433
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Fax | 909-469-2524
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Provider Business Mailing Address
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Address Line | 110 CALLE RENATA
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City | SAN DIMAS
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State | CA
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Zip | 91773
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Country | US
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Telephone | 909-599-7281
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Fax | 909-469-2524
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | NP10940
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License Number State | CA
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