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NPI Code Detail

MEDICARE: AIBAR HERBERTO HUATUCO M.D.

MEDICARE: AIBAR HERBERTO HUATUCO 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
1207RN0300XNephrology PhysicianA32630CA

Other Identifiers

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

General Provider Information

NPI Number : 1245223932
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIBAR HERBERTO HUATUCO M.D.
Provider Business Mailing Address
First Line : 1530 BESSIE AVE
Second Line : SUITE 102
City : TRACY
State : CA
Zip : 95376-3080
Country : US
Telephone Number : 209-836-1627
Fax Number : 209-836-5478
Provider Business Practice Location Address
First Line : 1530 BESSIE AVE
Second Line : SUITE 102
City : TRACY
State : CA
Zip : 95376-3080
Country : US
Telephone Number : 209-836-1627
Fax Number : 209-836-5478
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 07/08/2007

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