MEDICARE: DR. KAVITHA HUBBARD M.D.

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	207RN0300X	Nephrology Physician	A79279	CA

General Provider Information

NPI Number	:	1124058805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAVITHA HUBBARD M.D.

Provider Business Mailing Address
First Line	:	18055 IDALYN DR
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95033-8924
Country	:	US
Telephone Number	:	310-502-0851
Fax Number	:

Provider Business Practice Location Address
First Line	:	18055 IDALYN DR
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95033-8924
Country	:	US
Telephone Number	:	310-502-0851
Fax Number	:

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	02/21/2014

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