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General NPI Number Information
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NPI Number | 1588302806
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Entity Type | Individual
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Provider Name | DYLAN HUNT PA
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Gender | Male
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 04/14/2023
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Provider Practice Location Address
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Address Line | 13 POINTE SAN PABLO
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5158
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Country | US
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Telephone | 808-281-5044
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Fax |
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Provider Business Mailing Address
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Address Line | 13 POINTE SAN PABLO
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5158
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Country | US
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Telephone | 808-281-5044
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA61618
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License Number State | CA
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