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General NPI Number Information
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NPI Number | 1568490639
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Entity Type | Organization
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Legal Business Name | ROYCE L. HUTAIN, M.D., INC.
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 02/18/2013
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Provider Practice Location Address
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Address Line | 501 N CORNELL AVE
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City | FULLERTON
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State | CA
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Zip | 92831-2744
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Country | US
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Telephone | 714-992-2730
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Fax | 714-992-1918
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Provider Business Mailing Address
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Address Line | 501 N CORNELL AVE
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City | FULLERTON
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State | CA
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Zip | 92831-2744
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Country | US
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Telephone | 714-992-2730
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Fax | 714-992-1918
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ROYCE L HUTAIN
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Credential | M.D.
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Telephone | 714-992-2730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G35907
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License Number State | CA
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