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General NPI Number Information
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NPI Number | 1598781031
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Entity Type | Individual
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Provider Name | DOUGLAS V HULSTEDT MD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 147 EL DORADO ST STE C
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City | MONTEREY
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State | CA
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Zip | 93940-3127
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Country | US
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Telephone | 831-333-1207
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Fax | 831-333-9894
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Provider Business Mailing Address
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Address Line | 498 VAN BUREN ST
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City | MONTEREY
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State | CA
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Zip | 93940-2624
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Country | US
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Telephone | 831-402-8310
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | A423970
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License Number State | CA
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