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General NPI Number Information
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NPI Number | 1487889218
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Entity Type | Organization
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Legal Business Name | HUBBARD CHIROPRACTIC INC
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 4344 CONVOY ST STE K
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City | SAN DIEGO
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State | CA
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Zip | 92111-3737
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Country | US
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Telephone | 858-279-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 4344 CONVOY ST STE K
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City | SAN DIEGO
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State | CA
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Zip | 92111-3737
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Country | US
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Telephone | 858-279-7300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW ALEXANDER HUBBARD
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Credential | D.C.
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Telephone | 858-279-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC28496
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License Number State | CA
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