MEDICARE: LYNSEY HOWARD HUBBARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013008663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNSEY HOWARD HUBBARD

Provider Business Mailing Address
First Line	:	1180 OLYMPIC DR
Second Line	:	112
City	:	CORONA
State	:	CA
Zip	:	92881-3393
Country	:	US
Telephone Number	:	951-278-4717
Fax Number	:	951-272-2815

Provider Business Practice Location Address
First Line	:	1180 OLYMPIC DR
Second Line	:	112
City	:	CORONA
State	:	CA
Zip	:	92881-3393
Country	:	US
Telephone Number	:	951-278-4717
Fax Number	:	951-272-2815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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Directions to “ LYNSEY HOWARD HUBBARD ” Practice Location

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