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General NPI Number Information
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NPI Number | 1679777940
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Entity Type | Organization
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Legal Business Name | JOSEPH G HUBBARD MD INC
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4000 14TH ST STE 302
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City | RIVERSIDE
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State | CA
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Zip | 92501-4083
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Country | US
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Telephone | 951-682-3583
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 14TH ST STE 302
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City | RIVERSIDE
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State | CA
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Zip | 92501-4083
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Country | US
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Telephone | 951-682-3583
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. VALERIE L. PAYNE
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Credential | CMPE
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Telephone | 951-682-3583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G87070
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License Number State | CA
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